Provider Demographics
NPI:1538240460
Name:BILOLIKAR, SURESH G (MD)
Entity type:Individual
Prefix:DR
First Name:SURESH
Middle Name:G
Last Name:BILOLIKAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11885 E 12 MILE RD
Mailing Address - Street 2:SUITE # 302-B
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-3474
Mailing Address - Country:US
Mailing Address - Phone:586-582-7077
Mailing Address - Fax:586-582-7071
Practice Address - Street 1:11885 E 12 MILE RD
Practice Address - Street 2:SUITE # 302-B
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3474
Practice Address - Country:US
Practice Address - Phone:586-582-7077
Practice Address - Fax:586-582-7071
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010392382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA76933Medicare UPIN