Individual
SURESH SREEDHARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
219 BROOKS AVENUE NORTH, THIEF RIVER FALLS, MN 56701
(218) 681-4673
Mailing address
219 BROOKS AVENUE NORTH, THIEF RIVER FALLS, MN 56701
(218) 681-4673
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
47461
MN
208000000X
Pediatrics Physician
61310-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285665067
—
WI
Enumeration date
07/06/2006
Last updated
03/06/2015
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