Individual
DR. EDWARD WILLIAM SUPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
217 HARRISBURG AVE, THE HEART GROUP, LTD., LANCASTER, PA 17603-2964
(717) 397-5484
(717) 397-8407
Mailing address
217 HARRISBURG AVE, THE HEART GROUP, LTD., LANCASTER, PA 17603-2964
(717) 397-5484
(717) 397-8407
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD038497E
PA
207RI0011X
Interventional Cardiology Physician
MD038497E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010951250003
—
PA
Enumeration date
03/02/2006
Last updated
10/02/2008
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