Individual
DR. SURA U EDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4379 RIDGEWOOD CENTER DR, STE 102, WOODBRIDGE, VA 22192-8322
(703) 680-7950
(703) 680-7953
Mailing address
PO BOX 1100, STE 102, WHITE PLAINS, MD 20695-1100
(240) 245-0821
(240) 252-2141
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D0082246
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154522688
—
VA
01
—
C06778
GROUP PTAN
VA
Enumeration date
05/31/2007
Last updated
09/14/2016
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