Provider Demographics
NPI:1407803646
Name:GEHANI, SURESH K (MD)
Entity Type:Individual
Prefix:
First Name:SURESH
Middle Name:K
Last Name:GEHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 77000
Mailing Address - Street 2:DEPT 77263
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-0263
Mailing Address - Country:US
Mailing Address - Phone:313-343-1615
Mailing Address - Fax:313-343-1803
Practice Address - Street 1:468 CADIEUX ROAD
Practice Address - Street 2:
Practice Address - City:GROSSE POINT
Practice Address - State:MI
Practice Address - Zip Code:48230-1507
Practice Address - Country:US
Practice Address - Phone:313-343-1615
Practice Address - Fax:313-343-1803
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI034326207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4136230Medicaid
MI2208212761OtherBS
MI2208212761OtherBS
MI4136230Medicaid