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Individual

DANIEL G SCHUPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1990 CONNECTICUT AVE S, SARTELL, MN 56377-2554
(320) 257-5595
(320) 257-5596
Mailing address
PO BOX 7366, SAINT CLOUD, MN 56302-7366
(320) 257-5595
(320) 257-5596

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36703
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
108628C561
UCARE OF MINNESOTA
MN
01
16-03044
MEDICA
MN
01
2274043
ARAZ/ AMERICA'S PPO
MN
01
411772562
TRICARE
MN
01
965251042462
PREFERRED ONE
MN
01
973N1SC
BLUE CROSS BLUE SHIELD
MN
05
978725900
MN
01
HP48858
HEALTH PARTNERS
MN
Enumeration date
08/01/2005
Last updated
08/11/2011
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