Active NPI
Suresh R Naik MD SC
- Internal Medicine Physician
- Kenosha, WI
National Provider Identifier
1992903124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 20553
- Legal business name
- SURESH R NAIK MD SC
- Practice address
- 3535 30TH Ave
Suite 207
Kenosha, WI 53144-1632 - Phone
- (262) 658-1618
- Fax
- (262) 654-4562
- NPI assigned
- Jul 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Suresh R Naik, M.D.
- Title
- Owner
- Phone
- (262) 658-1618
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20553 | WI | Primary |
Addresses
Primary practice location
3535 30TH Ave
Suite 207
Kenosha, WI 53144-1632
Mailing address
3535 30TH Ave
Suite 207
Kenosha, WI 53144-1632
Phone (262) 658-1618
National Provider Directory
National Provider DirectoryLocations
3535 30th Ave
Ste 207
Kenosha, WI 53144
Phone (262) 204-7550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225065600000",
"number": "1992903124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3535 30TH AVE",
"address_2": "SUITE 207",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441632",
"telephone_number": "262-658-1618",
"fax_number": "262-654-4562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 30TH AVE",
"address_2": "SUITE 207",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531441632",
"telephone_number": "262-658-1618",
"fax_number": "262-654-4562"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURESH R NAIK MD SC",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-10",
"last_updated": "2008-10-27",
"status": "A",
"authorized_official_last_name": "NAIK",
"authorized_official_first_name": "SURESH",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "262-658-1618",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "WI",
"license": "20553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.