NPI 1003826900

Jennifer Supol, DO

Practitioner Specialist Bingham Farms, MI

Practice location

Address: 31500 Telegraph Rd 105, Bingham Farms, MI 48025-4367
Phone: (248) 540-8700
Fax: (248) 540-8701

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 5101014945 (MI)

Other Specialist providers in Michigan →

Registry record

NPI: 1003826900
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.