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Dr. Jonathan W Surdam, MD
Specialist in Bloomington, Indiana
NPI 1124009287

Jonathan W Surdam is a Specialist based in Bloomington, IN. Jonathan W Surdam practices in Bloomington, IN and has the professional credentials of MD. The NPI Number for Jonathan W Surdam is 1124009287 and holds a License No. 01058877 (Indiana).

The current practice location address for Jonathan W Surdam is 1302 S Rogers St, Bloomington, IN and can be reached out via phone at 812-333-2663 and via fax at 812-676-4131.

Location: 1302 S Rogers St, Bloomington, IN, 47401-5515
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124009287
Provider Name
Jonathan W Surdam
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1302 S Rogers St, Bloomington, IN, 47401-5515
Phone Number
812-333-2663
Fax Number
812-676-4131
Provider Enumeration Date
11/07/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00146258 01 IN RAILROAD MEDICARE
200479570 05 IN
institution
Provider Business Practice Location Address Details
Address
1302 S Rogers St
City
Bloomington
State
Indiana
Zip
47403-4752
Phone Number
812-333-2663
Fax Number
812-676-4131
person
Provider Business Mailing Address Details
Address
1302 S Rogers St
City
Bloomington
State
Indiana
Zip
47403-4752
Phone Number
812-333-2663
Fax Number
812-676-4131
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
01058877 (Indiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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