Provider Demographics
NPI:1962490375
Name:DUPAY, EDWARD R JR (DO)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:R
Last Name:DUPAY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3033 WINKLER AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916
Mailing Address - Country:US
Mailing Address - Phone:239-277-7070
Mailing Address - Fax:239-277-7071
Practice Address - Street 1:3033 WINKLER AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916
Practice Address - Country:US
Practice Address - Phone:239-277-7070
Practice Address - Fax:239-277-7071
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2022-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS4788207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0905249OtherUNITED HEALTHCARE
FL80519OtherBCBS & MEDICARE GROUP
FL15743OtherSTAYWELL
FL275660900OtherMEDICIAD GROUP NUMBER
FL046335300Medicaid
FL650075827OtherTAX ID FOR GROUP
FL1806973002OtherCIGNA
FL82973OtherBCBS
FL071682OtherAETNA NON HMO
FL1003858OtherPHP
FL201702OtherAMERIGROUP
FL15743OtherSTAYWELL
FLD60784Medicare UPIN
FL0720530001Medicare NSC