Provider Demographics
NPI:1629236054
Name:CUPKA, BRYAN J (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:J
Last Name:CUPKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 N GREENE ST
Mailing Address - Street 2:4A-150
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1524
Mailing Address - Country:US
Mailing Address - Phone:410-605-7060
Mailing Address - Fax:410-605-7937
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:4A-150
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7060
Practice Address - Fax:410-605-7937
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2016-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00739892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology