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Individual

KARSTEN DIRK KUEPPENBENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., C.G.P.

Contact information

Practice address
1130 MASSACHUSETTS AVE, THIRD FLOOR, CAMBRIDGE, MA 02138-5204
(617) 855-3966
(617) 441-8303
Mailing address
1130 MASSACHUSETTS AVE, THIRD FLOOR, CAMBRIDGE, MA 02138-5204
(617) 855-3966

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
219749
MA
2084P0800X
Psychiatry Physician
219749
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J29279
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/23/2006
Last updated
08/14/2012
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