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General NPI Number Information
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NPI Number | 1235683699
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Entity Type | Individual
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Provider Name | SREERAG ALUMPARAMBIL SURENDRAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 20000 HARVARD AVE
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City | WARRENSVILLE HEIGHTS
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State | OH
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Zip | 44122-6805
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Country | US
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Telephone | 216-491-7036
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Fax | 216-491-7776
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Provider Business Mailing Address
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Address Line | 1000 N OAK AVE
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City | MARSHFIELD
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State | WI
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Zip | 54449-5702
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Country | US
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Telephone | 715-387-5511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 70545-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10057160
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.150057
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License Number State | OH
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