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NPI Code Detail

MEDICARE: MR. MATTHIAS DUPONT M.D.

MEDICARE: MR. MATTHIAS DUPONT M.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1902106297
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHIAS DUPONT M.D.
Provider Business Mailing Address
First Line : 2311 S OVERLOOK RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-3106
Country : US
Telephone Number : 216-785-3344
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2010
Last Update Date : 11/02/2010

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