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Individual

MARK B SUPERSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
108 N SPRING ST, MANCHESTER, TN 37355-1563
(931) 728-3988
(931) 728-6530
Mailing address
108 N SPRING ST, MANCHESTER, TN 37355-1563
(931) 728-3988
(931) 728-6530

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
246
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3351041
TN
01
48499
BLUE CROSS
TN
01
5097239
CIGNA
TN
Enumeration date
08/09/2005
Last updated
10/07/2008
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