Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 234189 | MA |
Y | 207T00000X | Neurosurgeon | 60928 | MN |
NPI | 1023267267 |
---|---|
Provider Name | Dr. Durga Ram Sure |
First Address | Duluth, MN 55805-1951 |
Second Address | Duluth, MN 55805-1951 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2008 |
Last Update Date | 09/08/2016 |