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Individual

MALCOLM SHUPECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400
(513) 527-2275
Mailing address
5400 KENNEDY AVE, CINCINNATI, OH 45213-2664
(513) 281-3400
(513) 527-2275

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
00-38557
NC
207T00000X
Neurological Surgery Physician
35-091781
OH
2085R0202X
Diagnostic Radiology Physician
Primary
35-091781
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2966474
OH
05
8976094
NC
Enumeration date
08/01/2006
Last updated
04/01/2015
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