1720963119 NPI number — MISS SWARNA VARSHINI SURESH M.D.

Table of content: MISS SWARNA VARSHINI SURESH M.D. (NPI 1720963119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720963119 NPI number — MISS SWARNA VARSHINI SURESH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SURESH
Provider First Name:
SWARNA VARSHINI
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720963119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
04/27/2026
NPI Reactivation Date:
08/12/2026

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GME 10W, ONE HURLEY PLAZA
Provider Second Line Business Mailing Address:
SUITE 101, MOB MEDICAL OFFICE BUILDING
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-262-6426
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GME 10W, ONE HURLEY PLAZA
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-262-6426
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , with the licence number:  451055437 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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