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Individual

DR. CRAIG LEE CUPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, ED.D

Contact information

Practice address
1 BOONE RD, ATTN: MEDICAL STAFF SERVICES, BREMERTON, WA 98312-1894
(360) 475-4214
Mailing address
1 BOONE RD, ATTN: MEDICAL STAFF SERVICES, BREMERTON, WA 98312-1894
(360) 475-4214

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
G47673
CA

Other

Enumeration date
02/03/2006
Last updated
08/20/2010
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