MEDICARE: SURYA N SANKARAN MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1487692190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURYA N SANKARAN MD PC

Provider Business Mailing Address
First Line	:	4449 FASHION SQUARE BLVD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-5217
Country	:	US
Telephone Number	:	989-790-0007
Fax Number	:	989-790-7547

Provider Business Practice Location Address
First Line	:	651 M 55 E
Second Line	:
City	:	TAWAS CITY
State	:	MI
Zip	:	48763-9238
Country	:	US
Telephone Number	:	989-362-8681
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SURYA SANKARAN
Credential	:	M.D.
Telephone Number	:	989-362-8681

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	10/12/2007

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