Individual
LOUIS PUPPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10692 CRESTWOOD DR STE B, MANASSAS, VA 20109
(703) 754-1524
(703) 754-7661
Mailing address
10692 CRESTWOOD DR STE B, MANASSAS, VA 20109-4410
(703) 754-1524
(703) 754-7661
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101048370
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699802942
—
VA
Enumeration date
02/27/2007
Last updated
11/01/2018
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