1831768464 NPI number — TANYA MARIA KUPER MD

Table of content: TANYA MARIA KUPER MD (NPI 1831768464)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831768464 NPI number — TANYA MARIA KUPER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KUPER
Provider First Name:
TANYA
Provider Middle Name:
MARIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831768464
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 COMMISSIONERS RD EAST
Provider Second Line Business Mailing Address:
LONDON HEALTH SCIENCES CENTRE, DIVISION OF GENERAL SURG
Provider Business Mailing Address City Name:
LONDON
Provider Business Mailing Address State Name:
ONTARIO
Provider Business Mailing Address Postal Code:
N6A5W9
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3433 BROADWAY ST NE STE 115
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-312-1500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com