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1205247137
GRACE SUPPA
CHARLESTON, SC
NPI
1205247137
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Former Name
GRACE BERLIN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207RR0500X Internal Medicine, Rheumatology
(Licence: SC 83397)
Enumeration Date
2014-05-13
Last Update Date
2022-01-17
Business Address
GRACE SUPPA DO
171 ASHLEY AVE
CHARLESTON, SC 29425-2338
Phone number: 843-792-1414
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Mailing Address
GRACE SUPPA DO
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200
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