Individual
MICHAEL E CHUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
312 MIA DR, BRISTOL, TN 37620-7246
(423) 366-6005
Mailing address
312 MIA DR, BRISTOL, TN 37620-7246
(423) 366-6005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0000055171
TN
208600000X
Surgery Physician
4301060968
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457367302
—
MI
Enumeration date
07/31/2006
Last updated
12/12/2023
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