Individual
DR. SURENDRA KUMAR MILAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.E.P.
Contact information
Practice address
200 N UNION AVE, HAVRE DE GRACE, MD 21078-2907
(410) 939-3343
Mailing address
200 N UNION AVE, HAVRE DE GRACE, MD 21078-2907
(410) 939-3343
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
DOO15448
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030051901
—
MD
01
—
184666
MEDICARE PTAN
MD
Enumeration date
06/07/2006
Last updated
05/22/2013
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