Provider Demographics
NPI:1114982907
Name:TRUPO, FRANK J (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:TRUPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6812
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25362-0812
Mailing Address - Country:US
Mailing Address - Phone:304-346-4444
Mailing Address - Fax:304-346-6383
Practice Address - Street 1:331 LAIDLEY ST
Practice Address - Street 2:SUITE 510
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1619
Practice Address - Country:US
Practice Address - Phone:304-346-4444
Practice Address - Fax:304-346-6383
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV14394174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0042575000Medicaid
WVE68467Medicare UPIN
WV0042575000Medicaid