Provider Demographics
NPI:1487608964
Name:SARASWAT, SURESH CHANDRA (MD)
Entity type:Individual
Prefix:
First Name:SURESH
Middle Name:CHANDRA
Last Name:SARASWAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2461
Mailing Address - Country:US
Mailing Address - Phone:615-895-2388
Mailing Address - Fax:615-904-9413
Practice Address - Street 1:611 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2461
Practice Address - Country:US
Practice Address - Phone:615-895-2388
Practice Address - Fax:615-904-9413
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13076207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3184491Medicaid
TN15512OtherBLUE CROSS
TNB04133Medicare UPIN
TN3184491Medicaid