Paruchuri, Surendra P

Paruchuri, Surendra P is an individual health care provider with primary practice located at 707 N Logan Ave Danville Polyclinic, Ltd., Danville IL 61832-4360. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Paruchuri, Surendra P can be contacted via phone (217) 477-4730.

Contact Information

Primary practice address
707 N Logan Ave Danville Polyclinic, Ltd. Danville IL 61832-4360
Phone: (217) 477-4730
Fax: (217) 477-4749
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036061132 Illinois
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 036061132 Illinois

Profile Details

NPI number 1902847437
LBN Legal business name Paruchuri, Surendra P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jan 12th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902847437 NPPES
Indiana MEDICAID 100014800A
Indiana MEDICAID 036061132
Indiana Other 22387
Indiana Other 170580

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