Individual
SURESH K MENON
Active
Individual
SURESH K MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
23521
WV
207N00000X
Dermatology Physician
D55793
MD
207Q00000X
Family Medicine Physician
23521
WV
207Q00000X
Family Medicine Physician
D55793
MD
207R00000X
Internal Medicine Physician
D0055793
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811956311
—
MD
05
—
404724900
—
MD
01
—
61692304
BCBS
MD
01
—
P00110702
RAILROAD
MD
01
—
P01520669
RAILROAD MEDICARE
WV
Enumeration date
03/22/2006
Last updated
06/22/2021
Update your record
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