| Doctor Name: | DR. DILIP SURYAVANSHI |
| NPI Number: | 1104015387 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A112298 |
| Business Practice Address: | 1540 Healdsburg Ave Healdsburg, CA - 954483253 |
| Business Phone Number: | 7074734404 |
| Business Fax Number: | |
| Mailing Address: | 1375 University St, HEALDSBURG |
| State: | CA |
| Postal Code: | 954483382 |
| Phone Number: | 7074316500 |
| Fax Number: | |
| NPI Enumeration Date: | 10/23/2007 |
| NPI Last Update Date: | 12/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204F00000X |
| License Number: | A112298 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Transplant Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |