Healthcare Provider Details

I. General information

NPI: 1346672268
Provider Name (Legal Business Name): SURESH KUMAR SRINIVASAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 JOHNSON RD STE 208
STEUBENVILLE OH
43952-2372
US

IV. Provider business mailing address

380 SUMMIT AVE
STEUBENVILLE OH
43952-2667
US

V. Phone/Fax

Practice location:
  • Phone: 740-314-5138
  • Fax: 740-792-4171
Mailing address:
  • Phone: 740-283-7597
  • Fax: 740-283-7190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.135171
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35.135171
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD487090
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: