Provider Demographics
NPI:1518906130
Name:DUPUIS, STEVEN J (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:DUPUIS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2100 RAYBROOK ST SE
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7759
Mailing Address - Country:US
Mailing Address - Phone:616-235-5100
Mailing Address - Fax:616-235-5050
Practice Address - Street 1:2100 RAYBROOK ST SE
Practice Address - Street 2:SUITE # 300
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7759
Practice Address - Country:US
Practice Address - Phone:616-235-5100
Practice Address - Fax:616-235-5050
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-02-01
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Provider Licenses
StateLicense IDTaxonomies
MI5101007138207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE26725Medicare UPIN