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NPI Code Detail

MEDICARE: THOMAS TUPPER MD

MEDICARE: THOMAS TUPPER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMD13819ME

General Provider Information

NPI Number : 1215919279
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS TUPPER MD
Provider Business Mailing Address
First Line : 324 GANNETT DR
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-3270
Country : US
Telephone Number : 207-482-7800
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : BIDDEFORD
State : ME
Zip : 04005-9422
Country : US
Telephone Number : 207-283-7170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 09/25/2012

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Directions to “ THOMAS TUPPER MD” Practice Location

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