Provider Demographics
NPI:1003857269
Name:GUPTA, RITA (MD)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8926 WOODYARD RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4220
Mailing Address - Country:US
Mailing Address - Phone:301-868-7911
Mailing Address - Fax:301-868-2285
Practice Address - Street 1:8926 WOODYARD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4220
Practice Address - Country:US
Practice Address - Phone:301-868-7911
Practice Address - Fax:301-868-2285
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043346207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038009500Medicaid
MD368810100Medicaid
MD538505OtherALLIANCE
MD7579808003OtherCIGNA
MD915918OtherAETNA HMO
DCB6480004OtherBC/BS OF DC
MD493215OtherHEALTHLINK
MD538505OtherMAMSI
DC02810002OtherBC/BS OF DC
MD54319802OtherBC/BS MARYLAND
MD0004506157OtherAETNA MNG
3000178OtherUNITED HEALTHCARE
MD08245OtherAMERICAID
MD234814OtherTRIGON
MD7579808003OtherCIGNA
830004074Medicare PIN
DC02810002OtherBC/BS OF DC
MDG24218Medicare UPIN