Provider Demographics
NPI:1912114976
Name:CUPPETT, COURTNEY DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:DAWN
Last Name:CUPPETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8423 MARKET ST STE 207
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6778
Mailing Address - Country:US
Mailing Address - Phone:330-729-7901
Mailing Address - Fax:330-729-7915
Practice Address - Street 1:8423 MARKET ST STE 207
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6778
Practice Address - Country:US
Practice Address - Phone:330-729-7901
Practice Address - Fax:330-729-7915
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.142548207V00000X, 207VM0101X
PAMD436160207V00000X, 207VM0101X
WV22658207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology