Most Relevant Information
Provider Data
| NPI Number: | 1003557794 |
| Provider Name: | JESSICA ELIZA SUKHARAN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/05/2022 |
| Last Updated: | 04/05/2022 |
Provider Practice Location
2020 E 28TH ST STE 104
MINNEAPOLIS
MN
554071925
Practice Location Phone/Fax
| Phone: | 7633300770 |
| Fax: |
Provider Mailing Location
2020 E 28TH ST STE 104
MINNEAPOLIS
MN
554071925
Provider Mailing Phone/Fax
| Phone: | 7633300770 |
| Fax: |