Provider Demographics
NPI:1902888563
Name:STUPARICH, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:STUPARICH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Mailing Address - Street 2:ATTN: MCEUL-DCCS (CREDENTIALS), CMR 402
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:DE
Mailing Address - Phone:01149637-186-8839
Mailing Address - Fax:01149637-186-6133
Practice Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:INTERNAL MEDICINE CLINIC, CMR 402
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:DE
Practice Address - Phone:01149637-186-8100
Practice Address - Fax:01149637-186-8870
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
NE22839207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine