Provider Demographics
NPI:1366534307
Name:KARNE, SURESH (MD PHD)
Entity type:Individual
Prefix:
First Name:SURESH
Middle Name:
Last Name:KARNE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 LOWELL DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3763
Mailing Address - Country:US
Mailing Address - Phone:256-536-9031
Mailing Address - Fax:256-539-4240
Practice Address - Street 1:420 LOWELL DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3763
Practice Address - Country:US
Practice Address - Phone:256-536-9031
Practice Address - Fax:256-539-4240
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23431207RG0100X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000097266Medicaid
AL000097266OtherMEDICARE INDIVIDUAL PROVI
ALE324OtherMEDICARE GROUP PAYER #
ALE324OtherMEDICARE GROUP PAYER #