Individual
ERIC SUPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2817 ROCK MERRITT AVE STOP A, FORT BRAGG, NC 28310-0001
(910) 907-8922
(910) 907-6069
Mailing address
2817 ROCK MERRITT AVE STOP A, FORT BRAGG, NC 28310-0001
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101270191
VA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
1071
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2019
Last updated
08/25/2025
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