Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 02001097 | IN |
NPI | 1295732055 |
---|---|
Provider Name | Steven A Rupert |
First Address | Evansville, IN 47711-2998 |
Second Address | Evansville, IN 47711-2998 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 18/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100179690 | (05) | IN |
200850420A | (05) | IN |
64873391 | (05) | IN |
E16779 | (02) | IN |