Provider Demographics
NPI:1770506685
Name:CHUPPE, STEVEN V (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:V
Last Name:CHUPPE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1914
Mailing Address - Country:US
Mailing Address - Phone:701-258-0029
Mailing Address - Fax:701-258-0826
Practice Address - Street 1:1936 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1914
Practice Address - Country:US
Practice Address - Phone:701-258-0029
Practice Address - Fax:701-258-0826
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDT89010Medicare UPIN
ND4245Medicare ID - Type Unspecified