Gaurav Sanjay Suryawanshi, MD
Student in an Organized Health Care Education/Training Program in Minneapolis, MN. Individual provider (NPI-1).
NPI number1164042446
StatusActive
Last updated in NPPESMay 17, 2024
Details
- NPI
- 1164042446
- Entity type
- Individual (NPI-1)
- Name
- Gaurav Sanjay Suryawanshi
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 16, 2020
- Certification date
- May 12, 2024
- Last updated
- May 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 207R00000X | Internal Medicine | 74423 | MN |
Practice location
420 Delaware St SeMinneapolis, MN 55455-0341
Phone 612-625-8999
Mailing address
420 Delaware St Se, Mmc 36Minneapolis, MN 55455
Phone 612-625-8999
Other practice locations
2450 Riverside Ave
Minneapolis, MN 55454-1450
Minneapolis, MN 55454-1450
Phone 612-672-6000
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