Provider Demographics
NPI:1407819360
Name:SURAY, ANNA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIA
Last Name:SURAY
Suffix:
Gender:F
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:PO BOX 2304
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-1504
Mailing Address - Country:US
Mailing Address - Phone:304-723-4000
Mailing Address - Fax:304-794-7100
Practice Address - Street 1:3045 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 3 LEVEL 1
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3770
Practice Address - Country:US
Practice Address - Phone:304-723-4000
Practice Address - Fax:304-794-7100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV187632080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0110578000Medicaid
WVSU4054121Medicare ID - Type Unspecified
WVG38235Medicare UPIN