Individual
SURAYYA SOARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15200 KERCHEVAL ST, GROSSE POINTE PARK, MI 48230-1356
(313) 417-6100
(313) 417-6107
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
4301060351
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3517340
—
MI
Enumeration date
08/15/2005
Last updated
10/23/2020
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