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General NPI Number Information
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NPI Number | 1649261645
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Entity Type | Individual
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Provider Name | ERIC M TUPIS P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 3100 DURALEIGH RD STE 100
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City | RALEIGH
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State | NC
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Zip | 27612-8105
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Country | US
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Telephone | 919-788-8797
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Fax | 919-313-1276
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Provider Business Mailing Address
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Address Line | 120 WILLIAM PENN PLZ
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City | DURHAM
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State | NC
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Zip | 27704-2150
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Country | US
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Telephone | 919-220-5255
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Fax | 919-313-1276
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | COOO2786
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-06022
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9108044
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License Number State | FL
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