Provider Demographics
NPI:1578512331
Name:DUPREE, RALPH (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:DUPREE
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 50900
Mailing Address - Street 2:
Mailing Address - City:ELEELE
Mailing Address - State:HI
Mailing Address - Zip Code:96705-0900
Mailing Address - Country:US
Mailing Address - Phone:808-634-1548
Mailing Address - Fax:209-336-6406
Practice Address - Street 1:243 KEOKEO ROAD
Practice Address - Street 2:
Practice Address - City:ELEELE
Practice Address - State:HI
Practice Address - Zip Code:96705-0900
Practice Address - Country:US
Practice Address - Phone:808-634-1548
Practice Address - Fax:209-336-6406
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD8480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH100969Medicare PIN
HIH100971Medicare PIN
HIH100968Medicare PIN
HIH100970Medicare PIN
HIE66711Medicare UPIN