Individual
SANDARSH SURYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1 MEDICAL CENTER BLVD, DEPARTMENT OF PSYCHIATRY, WINSTON SALEM, NC 27157-0001
(314) 662-1682
(336) 716-7080
Mailing address
997 SAINT SEBASTIAN WAY, DEPARTMENT OF PSYCHIATRY, AUGUSTA, GA 30912-2613
(314) 662-1682
(336) 716-7080
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
075535
GA
390200000X
Student in an Organized Health Care Education/Training Program
172607
NC
Other
Enumeration date
07/19/2011
Last updated
07/11/2016
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