CHRISTINA MARIA SUPINO DO NPI 1073192555

NPI Information

NPI: 1073192555
Provider Name: CHRISTINA MARIA SUPINO, DO
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
4069 LAKE DR SE STE 312
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 267-8700
Get Directions

Christina Maria Supino, DO is a vascular surgery surgery in Grand Rapids, MI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Christina Maria Supino, DO NPI is 1073192555. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4069 LAKE DR SE STE 312
GRAND RAPIDS, MI
ZIP 49546-816
Phone: (616) 267-8700

The NPI 1073192555 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/3/2021 and was last updated on 6/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	2086S0129X	Surgery	Vascular Surgery	5151014961	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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