Individual
DR. ANGELINA A SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1028 E 3RD ST, CHATTANOOGA, TN 37403-2107
(423) 266-6751
(423) 763-4662
Mailing address
1028 E 3RD ST, CHATTANOOGA, TN 37403-2107
(423) 266-6751
(423) 763-4662
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD9173
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088871
BCBST
TN
05
—
3399761
—
TN
Enumeration date
10/05/2006
Last updated
01/30/2008
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