Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 10570 | MS |
NPI | 1164511374 |
---|---|
Provider Name | Dr. Suman Kumar Das |
First Address | Flowood, MS 39232-9521 |
Second Address | Flowood, MS 39232-9521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 16/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08922816 | (05) | MS |
C48204 | (02) | MS |