Individual
SANDRA H. PUPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13753
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115892
—
MS
05
—
009601090
—
AL
01
—
300074586
RAILROAD MEDICARE
—
01
—
730-74365
BLUE CROSS OF AL
—
Enumeration date
07/12/2005
Last updated
11/09/2013
Update your record
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