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Individual

DURGA R. KANURU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
110 RIDGE RD, MUNSTER, IN 46321-1574
(219) 836-0000
(219) 836-2788
Mailing address
110 RIDGE RD, MUNSTER, IN 46321-1574
(219) 836-0000
(219) 836-2788

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
01031561A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100168550
IN
01
256700I
MEDICARE PTAN
IN
Enumeration date
07/29/2005
Last updated
05/21/2009
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