Individual
MARK A KURIATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
300 E MAIDEN LN, SAINT JOSEPH, MI 49085-8516
(269) 429-7546
(269) 429-0807
Mailing address
300 E MAIDEN LN, SAINT JOSEPH, MI 49085-8516
(269) 429-7546
(269) 429-0807
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
5101012454
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0751100205
BLUE CROSS
—
01
—
0A10115
BCBSM GROUP
MI
01
—
1531892018
GROUP NPI
MI
05
—
350460011
—
MI
01
—
CG9582
PALMETTO GBA GROUP
MI
Enumeration date
08/31/2006
Last updated
04/03/2012
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