Provider Demographics
NPI:1326042144
Name:SURI, ATUL H (MD)
Entity Type:Individual
Prefix:
First Name:ATUL
Middle Name:H
Last Name:SURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7500 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 930
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3502
Mailing Address - Country:US
Mailing Address - Phone:301-345-2412
Mailing Address - Fax:301-345-3978
Practice Address - Street 1:7500 GREENWAY CENTER DR
Practice Address - Street 2:STE 930
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3502
Practice Address - Country:US
Practice Address - Phone:301-345-2412
Practice Address - Fax:301-345-3978
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2010-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0062825207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408258300Medicaid
MDH07441Medicare UPIN
MDG02110Medicare ID - Type UnspecifiedGROUP NUMBER
MDG02110P02Medicare ID - Type UnspecifiedRENDERING PROVIDER NUMBER