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Individual
MR. KANDASAMY SURESH
Active
Individual
MR. KANDASAMY SURESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5501005288
MI
225100000X
Physical Therapist
Primary
5501005288
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568640746
—
MI
05
—
4539664
—
MI
Enumeration date
02/10/2008
Last updated
06/03/2026
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