Provider Demographics
NPI:1033387352
Name:SURAL, PREETHI (MD)
Entity Type:Individual
Prefix:
First Name:PREETHI
Middle Name:
Last Name:SURAL
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:6400 GOLDSBORO RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5826
Mailing Address - Country:US
Mailing Address - Phone:301-320-3361
Mailing Address - Fax:301-320-0171
Practice Address - Street 1:6400 GOLDSBORO RD
Practice Address - Street 2:SUITE 330
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-5826
Practice Address - Country:US
Practice Address - Phone:301-320-3361
Practice Address - Fax:301-320-0171
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2017-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0082790207RI0200X
AZ49689207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ948190Medicaid
AZZ169907Medicare PIN
MI0M71670Medicare PIN