Provider Demographics
NPI:1407295975
Name:DAVID J DUPREE MD PC
Entity Type:Organization
Organization Name:DAVID J DUPREE MD PC
Other - Org Name:DAVID J DUPREE MD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-450-1200
Mailing Address - Street 1:766 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3001
Mailing Address - Country:US
Mailing Address - Phone:732-450-1200
Mailing Address - Fax:732-450-1220
Practice Address - Street 1:70 E FRONT ST FL 5
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1851
Practice Address - Country:US
Practice Address - Phone:732-450-1200
Practice Address - Fax:732-450-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08972900208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty