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Individual
JACOB EDWIN KUPERSTOCK
Active
Individual
JACOB EDWIN KUPERSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
255486
MA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
0101266254
VA
Other
Enumeration date
05/06/2012
Last updated
07/24/2019
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