Provider Demographics
NPI:1851121917
Name:DUPREE, DONALD JR
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:DUPREE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15210 INDUSTRIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-3308
Mailing Address - Country:US
Mailing Address - Phone:440-600-8003
Mailing Address - Fax:216-539-1424
Practice Address - Street 1:15210 INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-3308
Practice Address - Country:US
Practice Address - Phone:440-600-8003
Practice Address - Fax:216-539-1424
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator