Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 4301039896 | MI |
NPI | 1225036031 |
---|---|
Provider Name | Surendra Kaul |
First Address | Midland, MI 48640-4710 |
Second Address | Midland, MI 48640-4710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 20/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1384422 | (05) | MI |
B45973 | (02) | MI |