Provider Demographics
NPI:1619978657
Name:NEKURI, SURESH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SURESH
Middle Name:KUMAR
Last Name:NEKURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3977
Mailing Address - Country:US
Mailing Address - Phone:423-353-1175
Mailing Address - Fax:423-353-1177
Practice Address - Street 1:709 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3977
Practice Address - Country:US
Practice Address - Phone:423-851-4379
Practice Address - Fax:423-353-1177
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD35008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1512614Medicaid
TN38670042Medicare PIN
TN1512614Medicaid