Individual
SURENDER KURAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HARRINGTON ST, MOUNT CLEMENS, MI 48043-2920
(586) 493-8098
(586) 493-8706
Mailing address
1770 IOWA AVE STE 280, RIVERSIDE, CA 92507-7401
(951) 786-0801
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301047552
MI
2085R0202X
Diagnostic Radiology Physician
C1-0025606
DE
2085R0202X
Diagnostic Radiology Physician
ME110793
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300119457
MEDICARE RR PIN
MI
01
—
3005011051
BCBS INDIVIDUAL PIN #
MI
01
—
310E011330
BCBS GROUP #
MI
05
—
4267902
—
MI
05
—
4458682
—
MI
05
—
Q47552
—
SC
Enumeration date
06/19/2006
Last updated
08/19/2024
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