Supple, Kevin M

Supple, Kevin M is an individual health care provider with primary practice located at 3200 Northline Ave Suite 200, Greensboro NC 27408-7616. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Supple, Kevin M can be contacted via phone (336) 545-5000.

Contact Information

Primary practice address
3200 Northline Ave Suite 200 Greensboro NC 27408-7616
Phone: (336) 545-5000
Fax: (336) 545-5020
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36604 North Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 36604 North Carolina
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 36604 North Carolina

Profile Details

NPI number 1326049412
LBN Legal business name Supple, Kevin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Feb 24th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326049412 NPPES
North Carolina MEDICAID 8981007

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