Healthcare Provider Details

I. General information

NPI: 1235986860
Provider Name (Legal Business Name): DAVIDS KUPURSMITS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/01/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE STE 520
LANSING MI
48912-1899
US

IV. Provider business mailing address

1200 E MICHIGAN AVE STE 520
LANSING MI
48912-1899
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-5260
  • Fax:
Mailing address:
  • Phone: 517-364-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: