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Contact Information

MICHAEL SUPPLES, MD
GRADUATE MEDICAL EDUCATION OFC
MEDICAL CENTER BOULEVARD
WINSTON-SALEM, NC27157
 Phone: 336-716-4629
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MICHAEL SUPPLES · (Male)

NPI Number 1689037988
Status Active
Credentials MD
Entity Individual
Enumeration date 04/04/2016
Last updated 06/04/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01081839A
  • NC License # 2018-01503
Hospital affiliation(s)
  • WILLIAM N WISHARD MEMORIAL HOSPITAL - (Acute Care)
    720 ESKENAZI AVENUE
    INDIANAPOLIS, IN 46254
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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