Provider Demographics
NPI:1174254825
Name:SURI, HARPREET DK
Entity Type:Individual
Prefix:
First Name:HARPREET
Middle Name:DK
Last Name:SURI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 MARRIOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1333
Mailing Address - Country:US
Mailing Address - Phone:410-521-7874
Mailing Address - Fax:
Practice Address - Street 1:2133 W MULBERRY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-1123
Practice Address - Country:US
Practice Address - Phone:410-521-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health