Individual
DR. JEFFREY BRUCE PUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1602 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 343-8889
(910) 343-9990
Mailing address
1602 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 343-8889
(910) 343-9990
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
230
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
230
NC
213ES0131X
Foot Surgery Podiatrist
230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0809N
BCBS NC
NC
05
—
890809N
—
NC
01
—
E1549
MEDCOST
NC
01
—
E1551
MEDCOST
NC
01
—
P00959571
MEDICARE RAILROAD
NC
Enumeration date
03/08/2006
Last updated
09/18/2013
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