Healthcare Provider Details

I. General information

NPI: 1669604898
Provider Name (Legal Business Name): SARTHAK GUPTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR 6N216
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

10 CENTER DR 6N216
BETHESDA MD
20892-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-443-8541
  • Fax:
Mailing address:
  • Phone: 301-443-8541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD71719
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberD71719
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: