Individual
TONY WAYNE CANUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 CHATHAM MEDICAL PARK, ELKIN, NC 28621
(336) 835-3136
(336) 835-6038
Mailing address
500 CHATHAM MEDICAL PARK, ELKIN, NC 28621
(336) 835-3136
(336) 835-6038
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18615
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7921063
—
NC
Enumeration date
05/17/2006
Last updated
11/14/2013
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