Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 43274 | MN |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 43274 | MN |
NPI | 1104885763 |
---|---|
Provider Name | Sureshbabu N Ahanya |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Saint Paul, MN 55102-2387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 11/03/2021 |