Individual
DR. MICAL J KUPKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
77 NEALY BLVD, LANGLEY AFB, VA 23665-2023
(757) 764-3260
Mailing address
114 PELICAN PL, YORKTOWN, VA 23692-2983
(757) 225-8001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
010106772
VA
2083A0100X
Aerospace Medicine Physician
Primary
0101056772
VA
208D00000X
General Practice Physician
0101056772
VA
Other
Enumeration date
03/18/2006
Last updated
12/18/2024
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