NPIMap

Organization Active NPI

Surendra Kaul, M.D.-P.C.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Midland, MI
National Provider Identifier
1023202637
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
4301039896 Issued in MI
Legal business name
SURENDRA KAUL, M.D.-P.C.
Practice address
555 W Wackerly St
Suite 3625
Midland, MI 48640-4722
Phone
(989) 835-8625
Fax
(989) 839-8864
NPI assigned
Aug 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Surendra Kaul, M.D.NPI 1225036031
Title
President
Phone
(989) 835-8625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0402X 4301039896 MI Primary

Addresses

Primary practice location

555 W Wackerly St
Suite 3625
Midland, MI 48640-4722

Mailing address

555 W. Wackerly Street
Suite 3625
Midland, MI 48640-4715
Phone (989) 835-8625

Other identifiers 1

IdentifierTypeStateIssuer
138442210MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1023202637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W. WACKERLY STREET",
            "address_2": "SUITE 3625",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404715",
            "telephone_number": "989-835-8625",
            "fax_number": "989-839-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST",
            "address_2": "SUITE 3625",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404722",
            "telephone_number": "989-835-8625",
            "fax_number": "989-839-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURENDRA KAUL, M.D.-P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "KAUL",
        "authorized_official_first_name": "SURENDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-835-8625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MI",
            "license": "4301039896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138442210",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.