Individual
DR. SURESH BALENALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1968 N PEART RD, SUITE 1, CASA GRANDE, AZ 85122-2495
(520) 836-6636
Mailing address
PO BOX 13308, CHANDLER, AZ 85248-0039
(520) 836-6636
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28920
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
543365
—
AZ
Enumeration date
06/12/2006
Last updated
12/19/2014
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