Provider Demographics
NPI:1306844592
Name:GUPTA, LALIT KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:LALIT
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2957 NEWARK ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-3339
Mailing Address - Country:US
Mailing Address - Phone:727-946-0889
Mailing Address - Fax:
Practice Address - Street 1:11119 ROCKVILLE PIKE STE 101
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-881-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0078182207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
021128200OtherBLACK LUNG
021128200OtherBLACK LUNG
FL51168OtherBLUE CROSS BLUE SHIELD
FL038558100Medicaid
FL51168VMedicare PIN
FLP00984673OtherRR MCR