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Individual

DENNIS M SUPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 METROHEALTH DR, MHMC-PEDIATRICS, CLEVELAND, OH 44109-1900
(216) 778-5633
Mailing address
2500 METROHEALTH DR, MHMC-PEDIATRICS, CLEVELAND, OH 44109-1900
(216) 778-5633

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35049067
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0545593
OH
Enumeration date
07/10/2006
Last updated
07/08/2007
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