Provider Demographics
NPI:1770856932
Name:DUPUIS, PEARCE JAMES
Entity Type:Individual
Prefix:MR
First Name:PEARCE
Middle Name:JAMES
Last Name:DUPUIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 HEALTH PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-8242
Mailing Address - Country:US
Mailing Address - Phone:269-657-2550
Mailing Address - Fax:269-657-2285
Practice Address - Street 1:451 HEALTH PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-8242
Practice Address - Country:US
Practice Address - Phone:269-657-2550
Practice Address - Fax:269-657-2285
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101019802207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program