Individual
RONALDO B SUPENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48201-2273
(313) 832-6300
(313) 832-2075
Mailing address
611 MARTIN LUTHER KING JR BLVD, SUITE 702, DETROIT, MI 48201-2273
(313) 832-6300
(313) 832-8341
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301032101
MI
Other
Enumeration date
06/13/2006
Last updated
11/01/2022
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