| Surya Medical Group Sc | |
|
6125 Green Bay Rd Suite 100 Kenosha WI 53142-2928 | |
| (262) 564-8636 | |
| Not Available |
| Full Name | Surya Medical Group Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 6125 Green Bay Rd, Kenosha, Wisconsin |
| Authorized Official Name and Position | Ganesh N Pulla (DOCTOR) |
| Authorized Official Contact | 2625648636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Surya Medical Group Sc 6125 Green Bay Rd Suite 100 Kenosha WI 53142-2928 Ph: (262) 564-8636 | Surya Medical Group Sc 6125 Green Bay Rd Suite 100 Kenosha WI 53142-2928 Ph: (262) 564-8636 |
| NPI Number | 1043415631 |
|---|---|
| Provider Enumeration Date | 06/15/2007 |
| Last Update Date | 10/05/2007 |
| Medicare PECOS PAC ID | 5991773939 |
|---|---|
| Medicare Enrollment ID | O20040917001040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043415631 | NPI | - | NPPES |
| 21279800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Secondary |
| Provider Name | Ganesh N Pulla |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679620918 PECOS PAC ID: 0345218384 Enrollment ID: I20040920000113 |
| Provider Name | Bharathi Pulla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962559302 PECOS PAC ID: 6800864703 Enrollment ID: I20040920000129 |
Steven Schwimmer, Do Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5455 Sheridan Rd, 201, Kenosha, WI 53140 Phone: 262-654-2500 Fax: 252-654-2701 | |
Leilane U Sta Romana Mdsc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3734 7th Ave, Dominican Building Suite 15, Kenosha, WI 53140 Phone: 262-658-3706 | |
Genesis Medical Center Of Kenosha, S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1020 35th St, Kenosha, WI 53140 Phone: 262-652-3500 Fax: 262-925-8353 | |
Great Lakes Family Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142 Phone: 262-764-4390 Fax: 262-764-4396 | |
Gevinah Healthcare Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3100 Washington Rd, Kenosha, WI 53144 Phone: 310-933-5688 | |
Regina Capelli-scheidt M.d,s.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3601 30th Ave, Kenosha, WI 53144 Phone: 262-658-8862 Fax: 262-658-8874 |