# CHARLES J SUPERNAVAGE, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639337405
- **Authorized official:** MS. APRIL C EVANS CMM (OFFICE MANAGER)
- **Authorized official phone:** (301) 739-0400

## Contact information

- **Practice address:** 201 S CLEVELAND AVE, SUITE 403, HAGERSTOWN, MD 21740-5745
- **Practice address phone:** (301) 739-0400
- **Practice address fax:** (301) 739-0402
- **Mailing address:** 201 S CLEVELAND AVE, SUITE 403, HAGERSTOWN, MD 21740-5745
- **Mailing address phone:** (301) 739-0400
- **Mailing address fax:** (301) 739-0402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | D0026440 | MD | Yes |
| 231H00000X | Audiologist | 00963 | MD | — |
| 237600000X | Audiologist-Hearing Aid Fitter | 00963 | MD | — |

## Other

- **Enumeration date:** 05/29/2008
- **Last updated:** 05/29/2008