Provider Demographics
NPI:1831768464
Name:KUPER, TANYA MARIA (MD)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:MARIA
Last Name:KUPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COMMISSIONERS RD EAST
Mailing Address - Street 2:LONDON HEALTH SCIENCES CENTRE, DIVISION OF GENERAL SURG
Mailing Address - City:LONDON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N6A5W9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3433 BROADWAY ST NE STE 115
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413
Practice Address - Country:US
Practice Address - Phone:651-312-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program