Provider Demographics
NPI:1841750262
Name:MPOY, MUTSHIPAY CHRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:MUTSHIPAY
Middle Name:CHRISTIAN
Last Name:MPOY
Suffix:
Gender:M
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:DEPARTMENT OF RADIOLOGY STONY BROOK MEDICINE
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8460
Mailing Address - Country:US
Mailing Address - Phone:631-444-2484
Mailing Address - Fax:631-444-7538
Practice Address - Street 1:DEPARTMENT OF RADIOLOGY STONY BROOK MEDICINE
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-2484
Practice Address - Fax:631-444-7538
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program