Doctor Name: | THERESEANN HUPRIKAR |
NPI Number: | 1063892123 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | 5101021919 |
Business Practice Address: | 1215 E Michigan Ave Lansing, MI - 489121811 |
Business Phone Number: | 5173642766 |
Business Fax Number: | |
Mailing Address: | 1215 E Michigan Ave, LANSING |
State: | MI |
Postal Code: | 489121811 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/04/2015 |
NPI Last Update Date: | 06/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5101021919 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |