Suprock, Mark Douglas
Suprock, Mark Douglas is an individual health care provider with primary practice located at 10315 Hamptons Park Dr , Huntersville NC 28078-7217. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Suprock, Mark Douglas can be contacted via phone (704) 323-2800.Contact Information
Primary practice address
10315 Hamptons Park Dr
Huntersville NC 28078-7217
Phone: (704) 323-2800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 200601156 | North Carolina |
Profile Details
| NPI number | 1205858339 |
|---|---|
| LBN Legal business name | Suprock, Mark Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Dec 23rd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205858339 | NPPES |
| South Carolina | MEDICAID | N01150 | |
| South Carolina | MEDICAID | 1205858339 |
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