Request a Specialist

Want to learn more about MYOBLOC^®? Fill in the form below and one of our Supernus Reimbursement Specialists will reach out to you with more information.

Please fill in either your NPI or your state license number.

NPI ID Number*

We use your NPI number OR your state license number to validate that you are a healthcare provider. You are only required to provide one of these.

Forgot your National Provider Identifier? Look it up here

State License Number*

We use your NPI number OR your state license number to validate that you are a healthcare provider. You are only required to provide one of these.

Office ZIP Code

First Name (optional)

Last Name (optional)

Confirm Email

Speciality (optional)

Contact Preferences (check all that apply)*

Phone

In Person

Virtual

Phone Number

I understand that the contact information that I have provided will be used by a Supernus representative to contact me.*

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