Provider Demographics
NPI:1487952511
Name:SURI, BHAVNA (MD)
Entity type:Individual
Prefix:DR
First Name:BHAVNA
Middle Name:
Last Name:SURI
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 1:18511 MISSION VIEW DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2974
Mailing Address - Country:US
Mailing Address - Phone:408-779-9422
Mailing Address - Fax:
Practice Address - Street 1:18511 MISSION VIEW DR
Practice Address - Street 2:SUITE 120
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2974
Practice Address - Country:US
Practice Address - Phone:408-779-9422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241985207R00000X
NJ25MA09172400207RC0000X
CAA128083207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine