Provider Demographics
NPI:1639755671
Name:KAUSHAL, SURAJ (DO)
Entity type:Individual
Prefix:
First Name:SURAJ
Middle Name:
Last Name:KAUSHAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 7412011 DEPT OF ANESTHESIOLOGY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-273-6249
Mailing Address - Fax:314-747-5157
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ DEPT OF
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-273-6249
Practice Address - Fax:314-747-5157
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025029903207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program