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General NPI Number Information
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NPI Number | 1972890028
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Entity Type | Individual
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Provider Name | SHERLYANA SURJA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 3125 TRANSVERSE DR STE D
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City | TOLEDO
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State | OH
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Zip | 43614-8008
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Country | US
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Telephone | 419-383-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 ARLINGTON AVE STOP 1108
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City | TOLEDO
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State | OH
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Zip | 43614-2595
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Country | US
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Telephone | 419-383-5023
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Fax | 419-383-6235
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 35-148878
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | 4301113303
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | 35.148878
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 125060551
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License Number State | IL
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