Provider Demographics
NPI:1053406751
Name:KAUPP, CARA DOUVILLE (MD)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:DOUVILLE
Last Name:KAUPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CARA
Other - Middle Name:CHARRON
Other - Last Name:DOUVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:383 E DUNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-4216
Mailing Address - Country:US
Mailing Address - Phone:603-891-0083
Mailing Address - Fax:603-891-0847
Practice Address - Street 1:383 E DUNSTABLE RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-4216
Practice Address - Country:US
Practice Address - Phone:603-891-0083
Practice Address - Fax:603-891-0847
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203590Medicaid
NH30203590Medicaid
NHRE7265Medicare ID - Type Unspecified