Provider Demographics
NPI:1871910745
Name:RALPH A. DUPREE, MD, LLC
Entity type:Organization
Organization Name:RALPH A. DUPREE, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-634-1548
Mailing Address - Street 1:PO BOX 50900
Mailing Address - Street 2:ELEELE
Mailing Address - City:ELEELE
Mailing Address - State:HI
Mailing Address - Zip Code:96705-0900
Mailing Address - Country:US
Mailing Address - Phone:808-634-1548
Mailing Address - Fax:209-336-6406
Practice Address - Street 1:243 KEO KEO ROAD
Practice Address - Street 2:
Practice Address - City:ELEELE
Practice Address - State:HI
Practice Address - Zip Code:96705
Practice Address - Country:US
Practice Address - Phone:808-634-1548
Practice Address - Fax:209-336-6406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8480261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIE66711Medicare UPIN