Provider Demographics
NPI:1376734004
Name:KANHOUWA, SURYABALA (MD)
Entity Type:Individual
Prefix:DR
First Name:SURYABALA
Middle Name:
Last Name:KANHOUWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2700 MARTIN LUTHER KING JR AVE SE
Mailing Address - Street 2:ST ELIZABETH HOSPITAL
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032
Mailing Address - Country:US
Mailing Address - Phone:202-645-9770
Mailing Address - Fax:202-645-9811
Practice Address - Street 1:2700 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:ST ELIZABETH HOSPITAL
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2601
Practice Address - Country:US
Practice Address - Phone:202-645-9770
Practice Address - Fax:202-645-9811
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDDO014311207ZP0105X
DCMD025988207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine