Provider Demographics
NPI:1184897134
Name:SURA, SIDDHARTH P (MD)
Entity type:Individual
Prefix:DR
First Name:SIDDHARTH
Middle Name:P
Last Name:SURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13808 PROFESSIONAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7948
Mailing Address - Country:US
Mailing Address - Phone:704-717-5549
Mailing Address - Fax:704-602-6563
Practice Address - Street 1:415 N CENTER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5057
Practice Address - Country:US
Practice Address - Phone:828-328-3300
Practice Address - Fax:828-261-2080
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2014-01092207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology