Organization
DR KURUCHI SRINIVASAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURUCHI SRINIVASAN MD (PRESIDENT)
(215) 677-4444
Entity
Organization
Contact information
Practice address
9500 NORTHEAST AVE, PHILADELPHIA, PA 19115-3005
(215) 677-4444
(215) 677-4466
Mailing address
1227 SEROTA PL, PHILADELPHIA, PA 19115-2526
(215) 677-4444
(215) 677-4466
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011749
HIGHMARK BLUESHIELD
PA
01
—
3426863000
PERSONAL CHOICE
PA
01
—
3426863001
KEYSTONE GROUP
PA
Enumeration date
12/20/2007
Last updated
10/13/2009
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