Individual
MRS. MARY KURUVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1520 GERMANTOWN ST, DAYTON, OH 45408-1318
(937) 222-8111
(937) 496-2943
Mailing address
5070 PEBBLEBROOK DR, ENGLEWOOD, OH 45322
(937) 832-1320
(937) 496-2943
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35056398OHIO
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2961166
—
OH
Enumeration date
04/20/2007
Last updated
04/15/2015
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