Basic Information
Provider Information
NPI: 1659679710
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUPPMANN
FirstName: ALISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8 MEMORIAL MEDICAL CT STE 1
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296054400
CountryCode: US
TelephoneNumber: 8642953492
FaxNumber: 8642954817
Practice Location
Address1: 8 MEMORIAL MEDICAL CT STE 1
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296054400
CountryCode: US
TelephoneNumber: 8642953492
FaxNumber: 8642954817
Other Information
ProviderEnumerationDate: 03/14/2011
LastUpdateDate: 11/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZH0000XMD041282DCN Allopathic & Osteopathic PhysiciansPathologyHematology
207ZH0000X84935SCN Allopathic & Osteopathic PhysiciansPathologyHematology
207ZP0102XMD041282DCN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0213XMD041282DCN Allopathic & Osteopathic PhysiciansPathologyPediatric Pathology
207ZP0213X84935SCN Allopathic & Osteopathic PhysiciansPathologyPediatric Pathology
207ZP0102X84935SCY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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