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NPI Code Detail

MEDICARE: GARRY H RUPP MD

MEDICARE: GARRY H RUPP MD
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
1207KA0200XAllergy Physician35-03-1374OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497753685
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARRY H RUPP MD
Provider Business Mailing Address
First Line : PO BOX 183027 DEPT LB-05
Second Line :
City : COLUMBUS
State : OH
Zip : 43218-3027
Country : US
Telephone Number : 614-891-0550
Fax Number : 614-891-0429
Provider Business Practice Location Address
First Line : 5877 CLEVELAND AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-2859
Country : US
Telephone Number : 614-891-0550
Fax Number : 614-891-0429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 11/19/2007

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Directions to “ GARRY H RUPP MD” Practice Location

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