Individual
SURESH LAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5532
(602) 344-5859
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
21645
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
21645
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147456
—
AZ
Enumeration date
05/27/2006
Last updated
11/14/2011
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