Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD426818 | PA |
NPI | 1043254667 |
---|---|
Provider Name | Sanjeev Suri |
First Address | Butler, PA 16001-5713 |
Second Address | Butler, PA 16001-5713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |