Individual
JULIE A SUPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(434) 200-5895
(434) 200-7529
Mailing address
PO BOX 11646, LYNCHBURG, VA 24506-1646
(434) 200-5895
(434) 200-7529
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101243083
VA
208M00000X
Hospitalist Physician
Primary
0101243083
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225203698
—
VA
01
—
355576
ANTHEM
—
01
—
358457
ANTHEM
—
Enumeration date
04/28/2008
Last updated
02/20/2023
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