Provider Demographics
NPI:1598757221
Name:SUBEDI, GUNA (MD)
Entity type:Individual
Prefix:
First Name:GUNA
Middle Name:
Last Name:SUBEDI
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 1:625 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-2717
Mailing Address - Country:US
Mailing Address - Phone:540-635-7991
Mailing Address - Fax:540-636-2516
Practice Address - Street 1:625 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-2717
Practice Address - Country:US
Practice Address - Phone:540-635-7991
Practice Address - Fax:540-636-2516
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052506207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001163Medicare PIN