Provider Demographics
NPI:1376565713
Name:KRUPINSKY, BRIAN S (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:S
Last Name:KRUPINSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305C WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5348
Mailing Address - Country:US
Mailing Address - Phone:410-379-8300
Mailing Address - Fax:410-379-0228
Practice Address - Street 1:6305C WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5348
Practice Address - Country:US
Practice Address - Phone:410-379-8300
Practice Address - Fax:410-379-0228
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD180QMedicare PIN