Provider Demographics
NPI:1679731251
Name:SUR, MALINI DOLON (MD)
Entity type:Individual
Prefix:DR
First Name:MALINI
Middle Name:DOLON
Last Name:SUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 JOHNSON FERRY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1607
Mailing Address - Country:US
Mailing Address - Phone:404-300-2140
Mailing Address - Fax:
Practice Address - Street 1:980 JOHNSON FERRY RD STE 170
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1607
Practice Address - Country:US
Practice Address - Phone:404-300-2140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257588208600000X, 2086X0206X
GA84909208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology