Provider Demographics
NPI:1366538472
Name:DUPERRET, MICHAEL E (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:DUPERRET
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1601 N TUCSON BLVD
Mailing Address - Street 2:#18
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716
Mailing Address - Country:US
Mailing Address - Phone:520-795-8186
Mailing Address - Fax:520-324-0780
Practice Address - Street 1:1601 N TUCSON BLVD
Practice Address - Street 2:#18
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716
Practice Address - Country:US
Practice Address - Phone:520-795-8186
Practice Address - Fax:520-324-0780
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2008-04-10
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Provider Licenses
StateLicense IDTaxonomies
AZ17290207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D88953Medicare UPIN