Provider Demographics
NPI:1780659029
Name:BUPP, STEVEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:BUPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5160 E GLENN ST # 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1337
Mailing Address - Country:US
Mailing Address - Phone:520-747-8494
Mailing Address - Fax:520-748-2609
Practice Address - Street 1:5160 E GLENN ST # 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1337
Practice Address - Country:US
Practice Address - Phone:520-747-8494
Practice Address - Fax:520-748-2609
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2011-08-22
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Provider Licenses
StateLicense IDTaxonomies
KS193502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZMD19350Medicare PIN