Individual
DR. SURESH T. MAXIMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8631 FAUNTLEROY WAY SW, SEATTLE, WA 98136-2439
(206) 788-7998
Mailing address
8631 FAUNTLEROY WAY SW, SEATTLE, WA 98136-2439
(206) 788-7998
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
194648
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01541280
—
NY
05
—
015541280
—
NY
Enumeration date
12/19/2005
Last updated
01/28/2010
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