Provider Demographics
NPI:1447647276
Name:GUPTA, ANKUR (MD)
Entity type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 MEDICAL PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-681-6600
Mailing Address - Fax:
Practice Address - Street 1:2101 MEDICAL PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:301-681-6600
Practice Address - Fax:301-681-3799
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101266845207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology