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Individual

MICHELLE N KUPERMINC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708
(757) 953-5652
(757) 953-7134
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-9007
(757) 953-5652
(757) 953-7134

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
0101243918
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116017586
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023221835
VA
Enumeration date
05/08/2007
Last updated
12/02/2019
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