Individual
AMANDA KUPSTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2305 GENOA BUSINESS PARK DR STE 210, BRIGHTON, MI 48114-7005
(734) 712-1700
Mailing address
24 FRANK LLOYD WRIGHT DR STE J2000, ANN ARBOR, MI 48105-9484
(734) 747-6766
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301103795
MI
208600000X
Surgery Physician
63689
MN
Other
Enumeration date
07/02/2013
Last updated
08/22/2019
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