Organization
LEELA SURULI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEELA SURULI MD (OBSTETRICS GYNECOLOGY)
(734) 721-0707
Entity
Organization
Contact information
Practice address
4811 VENOY RD, WAYNE, MI 48184-2675
(734) 721-0707
Mailing address
4811 VENOY RD, WAYNE, MI 48184-2675
(734) 721-0707
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
LS032052
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1735312
—
MI
Enumeration date
04/11/2007
Last updated
06/21/2018
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