Provider Demographics
NPI:1215008982
Name:GUPTA, YUDH VIR (DR)
Entity Type:Individual
Prefix:DR
First Name:YUDH
Middle Name:VIR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW
Mailing Address - Street 2:SUITE 415
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-877-0698
Mailing Address - Fax:202-877-6959
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE 415
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-877-0698
Practice Address - Fax:202-877-6959
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD8820207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB93800Medicare UPIN
DC161221Medicare ID - Type Unspecified