Jolly, Surindar K

Jolly, Surindar K is an individual health care provider with primary practice located at 4020 Venoy Rd Ste#800, Wayne MI 48184-1869. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Neurology, which is considered as his primary health care specialty. Jolly, Surindar K can be contacted via phone (734) 721-6001.

Contact Information

Primary practice address
4020 Venoy Rd Ste#800 Wayne MI 48184-1869
Phone: (734) 721-6001
Fax: (734) 721-6003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X 055782 Michigan

Profile Details

NPI number 1164479911
LBN Legal business name Jolly, Surindar K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated May 5th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164479911 NPPES
Michigan Other 1308261622 BLUE CROSS BLUE SHIELD
Michigan Other 1308209371 BLUE CROSS BLUE SHIELD
Michigan MEDICAID 2918602 BLUE CROSS BLUE SHIELD

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