Provider Demographics
NPI:1619044955
Name:RUPE, CAROL ANNE (MD)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANNE
Last Name:RUPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CROSS PT
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NC
Mailing Address - Zip Code:27850-9457
Mailing Address - Country:US
Mailing Address - Phone:252-204-4259
Mailing Address - Fax:252-541-2765
Practice Address - Street 1:40 ANNA LOUISE LN
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-8648
Practice Address - Country:US
Practice Address - Phone:252-917-8410
Practice Address - Fax:252-541-2763
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36420207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013UNMedicaid
013UNOtherBCBS
2320377Medicare ID - Type Unspecified
NC89013UNMedicaid