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Individual

DAVID PAUL SUPINSKI JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
4881 SUGAR MAPLE DR., ER/SGOE, WRIGHT PATTERSON AFB, OH 45433-0000
(937) 257-0770
Mailing address
88 MDOS- ER / SGOE, WRIGHT PATTERSON AFB, OH 45433
(937) 257-0770

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
12/05/2006
Last updated
06/09/2009
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