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Individual
DR. SEAN A. CUPP
Active
Individual
DR. SEAN A. CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0430814
KS
207QS0010X
Sports Medicine (Family Medicine) Physician
0430814
KS
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35.124490
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109771
—
OH
05
—
200307140A
—
KS
Enumeration date
05/01/2006
Last updated
12/02/2020
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