Individual
SURESH NUKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 W FAIR AVE STE 332, MARQUETTE, MI 49855-5407
(906) 225-3922
(906) 225-4527
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-3922
(906) 225-4527
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301089054
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4940237
—
MI
01
—
P00365530
RAILROAD MEDICARE
MI
01
—
SN089054
BCBSM
MI
Enumeration date
10/17/2006
Last updated
04/21/2009
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