Individual
ANDREW DUPRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
935 W MAIN ST, PERU, IN 46970-1740
(765) 472-4344
(765) 472-7095
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003903
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201293800
—
IN
01
—
P01562926
RAILROAD MEDICARE
IN
Enumeration date
06/17/2015
Last updated
08/03/2016
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