Individual
KIMBERLY C SUPPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
595 MARTHA JEFFERSON DR STE 320, CHARLOTTESVILLE, VA 22911-4669
(434) 654-8715
Mailing address
595 MARTHA JEFFERSON DR STE 320, CHARLOTTESVILLE, VA 22911-4669
(434) 654-8715
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101276400
VA
208600000X
Surgery Physician
2001018694
MO
Other
Enumeration date
05/20/2006
Last updated
12/09/2022
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