MEDICARE: DR. STEVEN K HUPRICH PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301012640	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	680D710830	OTHER	MI	BCBS PIN

General Provider Information

NPI Number	:	1386773745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN K HUPRICH PHD

Provider Business Mailing Address
First Line	:	7457 FRANKLIN RD
Second Line	:	SUITE 210
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3611
Country	:	US
Telephone Number	:	248-807-2159
Fax Number	:

Provider Business Practice Location Address
First Line	:	7457 FRANKLIN RD
Second Line	:	SUITE 210
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3611
Country	:	US
Telephone Number	:	248-807-2159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2007
Last Update Date	:	03/28/2016

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