Provider Demographics
NPI:1710973375
Name:GUPTA, SEEMA A (MD)
Entity Type:Individual
Prefix:DR
First Name:SEEMA
Middle Name:A
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SEEMA
Other - Middle Name:
Other - Last Name:AGGARWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:121 CONGRESSIONAL LN
Mailing Address - Street 2:STE #412
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1542
Mailing Address - Country:US
Mailing Address - Phone:301-770-4636
Mailing Address - Fax:301-770-7860
Practice Address - Street 1:121 CONGRESSIONAL LN
Practice Address - Street 2:STE #412
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1542
Practice Address - Country:US
Practice Address - Phone:301-770-4636
Practice Address - Fax:301-770-7860
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63425207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I38387Medicare UPIN
DCG02680Medicare PIN