Individual
SURINDAR K JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4020 VENOY RD, STE#800, WAYNE, MI 48184-1869
(734) 721-6001
(734) 721-6003
Mailing address
4020 VENOY RD, STE#800, WAYNE, MI 48184-1869
(734) 721-6001
(734) 721-6003
Taxonomy
Speciality
Code
Description
License number
State
2084V0102X
Vascular Neurology Physician
Primary
055782
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1308209371
BLUE CROSS BLUE SHIELD
MI
01
—
1308261622
BLUE CROSS BLUE SHIELD
MI
05
—
2918602
—
MI
Enumeration date
05/27/2006
Last updated
05/05/2008
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