Individual
DAVID M KUPHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
188 ROCKWOOD LN, NEENAH, WI 54956-1983
(920) 725-4100
(920) 725-5528
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 683-5278
(920) 686-9674
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1774-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1774-023
STATE LICENSE
WI
Enumeration date
06/12/2006
Last updated
06/03/2021
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