Individual
SURESH CHANDRA GHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 FRANKFORD AVE, WAKELING BUILDING, PHILADELPHIA, PA 19124-2620
(215) 831-2355
(215) 831-2017
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-6335
(215) 807-8000
(215) 831-2017
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD032109L
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD032109L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008205440005
—
PA
01
—
0052523000
INDEPENDENCE BLUE CROSS
PA
01
—
037241
HIGHMARK BLUE SHIELD
PA
01
—
30065497
KEYSTONE MERCY
PA
01
—
30685MD032109L
HEALTH PARTNERS
PA
01
—
5574330
AETNA PPO
PA
01
—
6974266
AETNA HMO
PA
Enumeration date
07/24/2006
Last updated
10/20/2011
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