Provider Demographics
NPI:1467714576
Name:GUPTA, MOHIT (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHIT
Middle Name:
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 1:3 TINGEY SQ SE APT 409
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4940
Mailing Address - Country:US
Mailing Address - Phone:954-673-2382
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:UROLOGY, PHC 4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2000
Practice Address - Country:US
Practice Address - Phone:202-444-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299768208800000X
FLTRN17321208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology