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General NPI Number Information
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NPI Number | 1023202637
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Entity Type | Organization
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Legal Business Name | SURENDRA KAUL, M.D.-P.C.
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 10/20/2011
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Provider Practice Location Address
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Address Line | 555 W WACKERLY ST SUITE 3625
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City | MIDLAND
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State | MI
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Zip | 48640-4722
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Country | US
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Telephone | 989-835-8625
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Fax | 989-839-8864
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Provider Business Mailing Address
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Address Line | 555 W. WACKERLY STREET SUITE 3625
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City | MIDLAND
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State | MI
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Zip | 48640-4715
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Country | US
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Telephone | 989-835-8625
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Fax | 989-839-8864
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SURENDRA KAUL
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Credential | M.D.
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Telephone | 989-835-8625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 4301039896
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License Number State | MI
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