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General NPI Number Information
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NPI Number | 1134186471
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Entity Type | Organization
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Legal Business Name | K.R. SURESH PHYSICIANS, LLC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 21851 CENTER RIDGE RD 309
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3976
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Country | US
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Telephone | 440-333-8322
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Fax | 440-333-3180
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Provider Business Mailing Address
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Address Line | 21851 CENTER RIDGE RD 309
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3976
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Country | US
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Telephone | 440-333-8322
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Fax | 440-333-3180
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Authorized Official
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Title or Position | OWNER
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Name | KEELAPANDAL R SURESH
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Credential | MD.
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Telephone | 440-333-8322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 1543370
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License Number State | OH
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