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General NPI Number Information
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NPI Number | 1811217284
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Entity Type | Individual
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Provider Name | DAVID RUPP MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 1600 MEDICAL CENTER DR 1500
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City | HUNTINGTON
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State | WV
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Zip | 25701-3656
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Country | US
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Telephone | 304-691-1100
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Fax | 304-691-1134
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Provider Business Mailing Address
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Address Line | 1600 MEDICAL CENTER DR 1500
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City | HUNTINGTON
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State | WV
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Zip | 25701-3656
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Country | US
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Telephone | 304-691-1100
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Fax | 304-691-1134
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 25050
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25050
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License Number State | WV
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