Provider Demographics
NPI:1093374258
Name:SURAPANENI, SARVANI (MD)
Entity type:Individual
Prefix:MS
First Name:SARVANI
Middle Name:
Last Name:SURAPANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY HEALTH CENTER, 4201 ST. ANTOINE
Mailing Address - Street 2:SUITE 2 E
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-4525
Mailing Address - Fax:
Practice Address - Street 1:50 E. CANFIELD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2020-04-29
Deactivation Date:2020-01-17
Deactivation Code:
Reactivation Date:2020-04-29
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program