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General NPI Number Information
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NPI Number | 1912114976
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Entity Type | Individual
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Provider Name | COURTNEY DAWN CUPPETT MD
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 8423 MARKET ST STE 207
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City | BOARDMAN
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State | OH
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Zip | 44512-6778
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Country | US
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Telephone | 330-729-7901
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Fax | 330-729-7915
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Provider Business Mailing Address
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Address Line | 8423 MARKET ST STE 207
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City | BOARDMAN
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State | OH
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Zip | 44512-6778
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Country | US
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Telephone | 330-729-7901
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Fax | 330-729-7915
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35.142548
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD436160
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 22658
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD436160
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 35.142548
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License Number State | OH
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