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Individual

DAVID A SUPIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34012342
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
62865
MN

Other

Enumeration date
05/14/2013
Last updated
07/21/2022
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