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Individual
SURYA NALLANI
Active
Individual
SURYA NALLANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301073842
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104797195
—
MI
01
—
1108115181
BCBSM
MI
01
—
1821196551
COMMERCIAL
MI
01
—
23D1049104
CLIA
MI
Enumeration date
06/12/2006
Last updated
06/11/2013
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