Individual
DR. SURBJINDER S GURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 WELLNESS BLVD STE 109, IRMO, SC 29063-2872
(803) 749-1111
(803) 749-0050
Mailing address
7182 WOODROW ST STE 200, IRMO, SC 29063-2832
(803) 749-1111
(803) 749-0050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11931
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110188005
RAILROAD MEDICARE
SC
05
—
119311
—
SC
01
—
562124971
CHAMPUS/TRICARE
SC
Enumeration date
05/04/2006
Last updated
05/05/2024
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