Mullick, Suparna

Mullick, Suparna is an individual health care provider with primary practice located at 3036 Centre Oak Way , Germantown TN 38138-6302. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Mullick, Suparna can be contacted via phone (901) 572-0005.

Contact Information

Primary practice address
3036 Centre Oak Way Germantown TN 38138-6302
Phone: (901) 572-0005
Fax: (901) 572-1102
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2006013531 Missouri
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 49897 Tennessee

Profile Details

NPI number 1366547713
LBN Legal business name Mullick, Suparna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Jul 27th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366547713 NPPES
Missouri MEDICAID 200382901

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