Provider Demographics
NPI:1073585261
Name:UPPAL, ARVINDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVINDER
Middle Name:
Last Name:UPPAL
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 1:11251 INDEPENDENCE WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10700 CHARTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3631
Practice Address - Country:US
Practice Address - Phone:443-917-2855
Practice Address - Fax:410-346-5775
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00558682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKA80OtherB/C B/S
MD333800200Medicaid
MDJ062OtherB/C B/S
DC2849OtherB/C B/S
MD013069A00Medicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 99
MDJ062OtherB/C B/S
MD434LA468Medicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 01
MDH13344Medicare UPIN
MD333800200Medicaid
DE011556A20Medicare ID - Type UnspecifiedLOCALITY/JURIS. 02 DC/DE
MD435LA467Medicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 02
MDCD4495Medicare ID - Type UnspecifiedRAILROAD MEDICARE