Provider Demographics
NPI:1376506220
Name:DUPUIS, MICHAEL (M D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DUPUIS
Suffix:
Gender:M
Credentials:M D
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 6640
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-0640
Mailing Address - Country:US
Mailing Address - Phone:850-982-8025
Mailing Address - Fax:
Practice Address - Street 1:3107 N H ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-1111
Practice Address - Country:US
Practice Address - Phone:850-435-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME26893207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057485600Medicaid
FL057485600Medicaid
FLA36151Medicare UPIN
175357BMedicare PIN