Individual
DAVID SURPRENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
125070659
IL
207N00000X
Dermatology Physician
35138872
OH
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
01085760A
IN
Other
Enumeration date
03/31/2016
Last updated
10/08/2021
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