Provider Demographics
NPI:1649285305
Name:SURTANI, NIRMAL K (MD)
Entity type:Individual
Prefix:DR
First Name:NIRMAL
Middle Name:K
Last Name:SURTANI
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 1:3600 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5407
Mailing Address - Country:US
Mailing Address - Phone:800-622-6575
Mailing Address - Fax:
Practice Address - Street 1:2610 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-9684
Practice Address - Country:US
Practice Address - Phone:765-683-4400
Practice Address - Fax:765-213-3713
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040522A207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000087020OtherANTHEM PIN
IN200031677OtherRAILROAD MEDICARE
IN200159310Medicaid
IN200159310Medicaid
IN000000087020OtherANTHEM PIN