Individual
DR. KEELAPANDAL R SURESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21851 CENTER RIDGE RD, 309, ROCKY RIVER, OH 44116-3976
(440) 333-8322
Mailing address
21245 LORAIN RD, STE 206, FAIRVIEW PARK, OH 44126-2140
(440) 895-5056
(440) 333-2935
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
35059258
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000543804
ANTHEM
—
05
—
0880917
—
OH
01
—
9273172
MEDICARE PHYSICIAN GROUP
—
Enumeration date
05/03/2006
Last updated
03/29/2017
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