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General NPI Number Information
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NPI Number | 1013906262
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Entity Type | Individual
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Provider Name | DANIEL J. MUPPIDI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 61 LINCOLN ST SUITE 208
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City | FRAMINGHAM
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State | MA
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Zip | 01702-8264
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Country | US
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Telephone | 508-393-0077
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Fax | 508-628-5410
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Provider Business Mailing Address
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Address Line | 61 LINCOLN STREET SUITE 208
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City | FRAMINGHAM
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State | MA
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Zip | 01702
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Country | US
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Telephone | 508-628-5400
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Fax | 508-628-5410
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 79117
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License Number State | MA
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