Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB EDWIN KUPERSTOCK, M.D.
ActiveJACOB EDWIN KUPERSTOCK, M.D. is a Facial Plastic Surgery healthcare provider located in FAIRFAX, Virginia. NPI 1700145182 is currently active in the NPPES registry. Verify at CMS.
Facial Plastic Surgery · FAIRFAX, VA
Registration Details
- NPI Number
- 1700145182
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 6, 2012 (14.283793398265 yrs)
- Last Updated
- Jul 24, 2019
- Licenses
-
255486 (MA)0101266254 (VA)
Practice Information
- Address
-
3801 UNIVERSITY DR STE 300FAIRFAX, VA, 22030Browse VA providers · Browse ZIP 22030
- Phone
- 7033838130
- Fax
- 7033837355
- Primary Specialty
-
Facial Plastic Surgery
207YX0905X
- Additional Specialty
- Facial Plastic Surgery
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.