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NPI Code Detail

MEDICARE: DR. MARY E RUPP MD

MEDICARE:  DR. MARY E 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
1207Q00000XFamily Medicine Physician4301063298MI

General Provider Information

NPI Number : 1528066156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY E RUPP MD
Provider Business Mailing Address
First Line : 322 W GRAND RIVER AVE
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-1655
Country : US
Telephone Number : 810-202-7115
Fax Number : 810-225-7774
Provider Business Practice Location Address
First Line : 322 W GRAND RIVER AVE
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-1655
Country : US
Telephone Number : 810-202-7115
Fax Number : 810-225-7774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 01/13/2026

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Directions to “ DR. MARY E RUPP MD” Practice Location

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