Provider Demographics
NPI:1093018673
Name:RUPPERT, ARTHUR SHAWN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:SHAWN
Last Name:RUPPERT
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HIGHWAY 34 S BLDG C-3
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1902
Mailing Address - Country:US
Mailing Address - Phone:732-866-2282
Mailing Address - Fax:
Practice Address - Street 1:201 HIGHWAY 34 S BLDG C-3
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1902
Practice Address - Country:US
Practice Address - Phone:732-866-2282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant