Individual
WALTER JOSPEH SUROWIEC JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.,F.A.C.S.
Contact information
Practice address
1340 BROAD AVE, STE 420, GULFPORT, MS 39501-2404
(228) 575-1500
(228) 575-1528
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 575-1500
(228) 575-1528
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
022945
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1498050
—
LA
Enumeration date
07/25/2006
Last updated
07/11/2014
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