Provider Demographics
NPI:1174191431
Name:SURESH, SATHISH (MD)
Entity Type:Individual
Prefix:
First Name:SATHISH
Middle Name:
Last Name:SURESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ASCENSION GENESYS, GME DEPT
Mailing Address - Street 2:ONE GENESYS PKWY
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439
Mailing Address - Country:US
Mailing Address - Phone:810-606-5000
Mailing Address - Fax:
Practice Address - Street 1:ASCENSION GENESYS HOSPITAL
Practice Address - Street 2:ONE GENESYS PKWY
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-4843
Practice Address - Country:US
Practice Address - Phone:810-606-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program