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General NPI Number Information
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NPI Number | 1639345200
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Entity Type | Organization
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Legal Business Name | S.M. KAURA M.D., PLLC
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 6801 ALLEN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-2007
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Country | US
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Telephone | 313-382-3400
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Fax | 313-382-0150
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Provider Business Mailing Address
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Address Line | 6801 ALLEN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-2007
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Country | US
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Telephone | 313-382-3400
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Fax | 313-382-0150
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | DR. SURINDER MOHAN KAURA
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Credential | M.D.
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Telephone | 313-382-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | SK036001
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License Number State | MI
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