Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Surya Medical Group SC

Organization Geriatric Medicine (Family Medicine) Physician · NPI 1043415631

Surya Medical Group SC is a Geriatric Medicine (Family Medicine) Physician in Kenosha, Wisconsin. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2

Practice location Address checks out

6125 Green Bay Rd Ste 100
Kenosha, WI 53142-2928
Phone: (262) 564-8636
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Family Medicine) Physician (primary) Taxonomy 207QG0300X
Nephrology Physician Taxonomy 207RN0300X

Record details

NPI number1043415631
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ganesh Pulla — Doctor · (262) 564-8636
NPI enumeratedJune 15, 2007
Last updated in NPPESOctober 5, 2007
Mailing address6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2928

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