Healthcare Provider Details

I. General information

NPI: 1922265321
Provider Name (Legal Business Name): NAVDEEP SINGH UPPAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 S CHALKLEY RD
CHESTER VA
23831
US

IV. Provider business mailing address

5000 COX RD
GLEN ALLEN VA
23060-9263
US

V. Phone/Fax

Practice location:
  • Phone: 804-796-3636
  • Fax: 814-837-4752
Mailing address:
  • Phone: 804-968-5700
  • Fax: 814-837-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD444370
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101265063
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: