Provider Demographics
NPI:1285371864
Name:VANGIPURAM SURESH, SRIKRISHNA (MD)
Entity type:Individual
Prefix:DR
First Name:SRIKRISHNA
Middle Name:
Last Name:VANGIPURAM SURESH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISHNA
Other - Middle Name:
Other - Last Name:VANGIPURAM SURESH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:601 N CAROLINE ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0006
Mailing Address - Country:US
Mailing Address - Phone:408-368-9110
Mailing Address - Fax:
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0006
Practice Address - Country:US
Practice Address - Phone:408-368-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAJ4147357207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery