Provider Demographics
NPI:1457779506
Name:GUHA, RAHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:GUHA
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 1:2025 TATE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1116
Mailing Address - Country:US
Mailing Address - Phone:434-200-2905
Mailing Address - Fax:434-200-3714
Practice Address - Street 1:2025 TATE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1116
Practice Address - Country:US
Practice Address - Phone:434-200-2905
Practice Address - Fax:434-200-3714
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2023-09-18
Deactivation Date:2020-07-31
Deactivation Code:
Reactivation Date:2020-08-14
Provider Licenses
StateLicense IDTaxonomies
VA31092084N0600X
NJ25MA117866002084N0400X
VA614572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology