Sureddi, Koteswar Rao

Sureddi, Koteswar Rao is an individual health care provider with primary practice located at 1400 Bryan Dr Suite 300, Durant OK 74702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sureddi, Koteswar Rao can be contacted via phone (580) 924-1700.

Contact Information

Primary practice address
1400 Bryan Dr Suite 300 Durant OK 74702
Fax: (580) 924-1736
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11978 Oklahoma

Profile Details

NPI number 1780621052
LBN Legal business name Sureddi, Koteswar Rao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Sep 7th, 2012 - about 13 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 1780621052 NPPES
Oklahoma MEDICAID 100014110A

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