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Individual
BRENDA B SURLES
Active
Individual
BRENDA B SURLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
052838
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
964775487A
—
GA
05
—
964775487C
—
GA
Enumeration date
08/10/2006
Last updated
06/19/2012
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