SURINDAR K JOLLY (NPI# 1164479911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164479911 |
| Entity Type | Individual |
| Full Name | SURINDAR K JOLLY |
| Credential | M.D. |
| Practice Address |
4020 Venoy Rd Ste#800 Wayne MI 48184-1869 |
| Practice Telephone | 7347216001 |
| Practice Fax Number | 7347216003 |
| Mailing Telephone | 7347216001 |
| Mailing Fax Number | 7347216003 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2008-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
055782 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BLUE SHIELD | 1308209371 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 1308261622 | 01 |
| MI | 2918602 | 05 |
| Street Address |
4020 VENOY RD STE#800 |
| City | WAYNE |
| State | MI |
| Zip Code | 48184-1869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194794412 | Adilakshmi Kaza | Obstetrics & Gynecology | 4020 Venoy Rd, Suite 400, Wayne, MI 48184-1869 | 2006-03-17 |
| 1477711414 | Chawki M Fakih | Pharmacist | 4020 Venoy Rd, Wayne, MI 48184-1869 | 2008-05-27 |
| 1407042922 | Jolly Neurological Clinic PC | Psychiatry & Neurology | 4020 Venoy Rd, 800, Wayne, MI 48184-1869 | 2007-09-18 |
| 1932237864 | Stars Investment Inc | Pharmacy | 4020 Venoy Rd, Suite 900, Wayne, MI 48184-1869 | 2007-03-01 |
| 1760527659 | Stars Investment Inc | Public Health or Welfare | 4020 Venoy Rd, Ste 200a, Wayne, MI 48184-1869 | 2007-02-20 |
| 1801969472 | Luningning V Regalado | Internal Medicine | 4020 Venoy Rd, Wayne, MI 48184-1869 | 2006-11-15 |
| 1275618027 | Michigan Cardiology Associates PC | Internal Medicine | 4020 Venoy Rd, Suite 200, Wayne, MI 48184-1869 | 2006-10-26 |
| 1699866509 | Rajesh Chander Gulati | Internal Medicine | 4020 Venoy Rd, Suite 200, Wayne, MI 48184-1869 | 2006-09-27 |
| 1013967819 | John W Armstead | Obstetrics & Gynecology | 4020 Venoy Rd, Suite 400, Wayne, MI 48184-1869 | 2006-05-11 |
| 1780645036 | Mansoor G Naini | Internal Medicine | 4020 Venoy Rd, Suite 200, Wayne, MI 48184-1869 | 2006-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215570932 | Wayne Rx | Pharmacy | 4603 Wayne Rd, Wayne, MI 48184 | 2019-10-25 |
| 1669902433 | Randi Oswald | Massage Therapist | 34336 Richard St., Wayne, MI 48184 | 2017-06-14 |
| 1306393822 | Amanda Anastasoff | Technician, Other | 35640 West Michigan Avenue, Wayne, MI 48184 | 2016-09-01 |
| 1871941302 | Christopher Schrimscher | Technician, Other | 34560 Michigan Avenue W, Wayne, MI 48184 | 2016-05-25 |
| 1659757334 | Anna Bondy | Technician, Other | 35640 Michigan Ave. West, Wayne, MI 48184 | 2015-08-05 |
| 1992184550 | Carrie Walrath | Community Health Worker | 4234 Niagara, Wayne, MI 48184 | 2015-05-28 |
| 1588043459 | Suzanne Cutlip | Case Manager/Care Coordinator | 35425 Michigan Ave. W. Suite 1, Wayne, MI 48184 | 2015-05-26 |
| 1285021295 | Alicia Allen | Technician, Other | 35640 Michigan Avenue West, Wayne, MI 48184 | 2015-04-17 |
| 1164843850 | Julia Krivoy | Nurse Anesthetist, Certified Registered | 33155 Annapolis St., Beaumont/oakwood Hospital - Wayne, Wayne, MI 48184 | 2013-12-23 |
| 1992130553 | One Stop Pharmacy LLC | Pharmacy | 33950 Van Born Rd, Wayne, MI 48184 | 2013-09-13 |
| Find all providers in zip 48184 | ||||
| Taxonomy Code | 2084V0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Vascular Neurology |
| Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356888044 | Jenny Peih-chir Tsai | Psychiatry & Neurology | 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 | 2017-01-19 |
| 1699227116 | Neuro Team One Pllc | Psychiatry & Neurology | 31500 Telegraph Rd Ste 115, Bingham Farms, MI 48025-4302 | 2016-11-01 |
| 1265986806 | Xavier Md PC | Psychiatry & Neurology | 31500 Telegraph Rd Ste 115, Bingham Farms, MI 48025-4302 | 2016-08-11 |
| 1730507930 | Kavit Shah | Psychiatry & Neurology | 2799 W. Grand Blvd, Detroit, MI 48202 | 2014-04-03 |
| 1598023665 | George Matthew Dillon | Psychiatry & Neurology | 34025 Harper Ave, Clinton Township, MI 48035 | 2012-04-26 |
| 1902035819 | Vivek Rai | Psychiatry & Neurology | 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503-2515 | 2009-07-13 |
| 1043452337 | Muhib Alam Khan | Psychiatry & Neurology | 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503-2515 | 2009-04-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.