Healthcare Provider Details

I. General information

NPI: 1093747289
Provider Name (Legal Business Name): DAVID DAWSON TUPPONCE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BIRCH ST
HOLYOKE MA
01040
US

IV. Provider business mailing address

40 ICE POND DR
NORTHAMPTON MA
01062-9501
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2608
  • Fax: 413-540-5005
Mailing address:
  • Phone: 413-584-3572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number214926
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: