Individual
SURESH BALASUBRAMONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Mailing address
186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
(304) 354-9244
(304) 354-9323
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20866
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1808807-000
—
WV
Enumeration date
07/19/2005
Last updated
07/08/2010
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