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Individual

BRENDA B SURLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1485 JESSE JEWELL PKWY NE, SUITE 200, GAINESVILLE, GA 30501-3806
(770) 534-5255
(770) 287-3871
Mailing address
1485 JESSE JEWELL PKWY NE, SUITE 200, GAINESVILLE, GA 30501-3806
(770) 534-5255
(770) 287-3871

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
052838
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
964775487A
GA
05
964775487C
GA
Enumeration date
08/10/2006
Last updated
06/19/2012
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