Doctor Name: | DR. BHAVDEEP K GUPTA |
NPI Number: | 1790735181 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD, FACC |
License Number: | 0101051058 |
Business Practice Address: | 1030 Hillpoint Blvd N Suffolk, VA - 234348470 |
Business Phone Number: | 7575390444 |
Business Fax Number: | 7575394824 |
Mailing Address: | 7007 Harbour View Blvd, Suite 108 SUFFOLK |
State: | VA |
Postal Code: | 234353657 |
Phone Number: | 7572152784 |
Fax Number: | 7572152728 |
NPI Enumeration Date: | 05/10/2006 |
NPI Last Update Date: | 02/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0101051058 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |