Individual
ARTHUR O DUPPSTADT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001288
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001011ZDJ0
MEDICARE PTAN
—
01
—
001965801
HIGHMARK PROVIDER NUMBER
—
05
—
1026200260001
—
PA
01
—
1518161413
NPI TYPE 2
—
01
—
OEG001288
OPTOMETRIC LICENSE
PA
Enumeration date
11/16/2006
Last updated
09/17/2014
Update your record
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