NPI 1124009287

Jonathan W Surdam, MD

Practitioner Specialist Bloomington, IN

Practice location

Address: 1302 S Rogers St, Bloomington, IN 47403-4752
Phone: (812) 333-2663
Fax: (812) 676-4131
Mailing address: 583 S Clarizz Blvd, Bloomington, IN 47401-5515

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 01058877 (IN)

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Registry record

NPI: 1124009287
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Nov 2005
Record last updated: 23 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.