Individual
DAVID SURPRENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 SE 4TH ST, EVANSVILLE, IN 47708-1607
(812) 463-4306
Mailing address
120 SE 4TH ST, EVANSVILLE, IN 47708-1607
(812) 463-4306
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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