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General NPI Number Information
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NPI Number | 1497753685
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Entity Type | Individual
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Provider Name | GARRY H RUPP MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 5877 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43231-2859
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Country | US
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Telephone | 614-891-0550
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Fax | 614-891-0429
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Provider Business Mailing Address
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Address Line | PO BOX 183027 DEPT LB-05
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City | COLUMBUS
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State | OH
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Zip | 43218-3027
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Country | US
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Telephone | 614-891-0550
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Fax | 614-891-0429
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 35-03-1374
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License Number State | OH
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