Individual
ELISABETH MARTA KUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
265 TANGLEWOOD LN, E1, SILVERTHORNE, CO 80498
(970) 468-1003
(970) 262-2196
Mailing address
PO BOX 1292, FRISCO, CO 80443-1292
(970) 668-1791
(970) 262-2196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-10576
ID
207Q00000X
Family Medicine Physician
MR-0938
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1196321
MEDICARE PTAN
ID
05
—
807773500
—
ID
Enumeration date
07/05/2007
Last updated
04/17/2015
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