Individual
DR. KEITH H KUPPLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 DEBARTOLO PL, SUITE 2750, YOUNGSTOWN, OH 44512-7004
(330) 758-7703
(330) 758-4930
Mailing address
250 DEBARTOLO PL, SUITE 2750, YOUNGSTOWN, OH 44512-7004
(330) 758-7703
(330) 758-4930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35045473
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35045473
OH
207RC0000X
Cardiovascular Disease Physician
MD043737L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01483298
—
PA
05
—
0540025
—
OH
Enumeration date
10/27/2005
Last updated
01/10/2013
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