Individual
SHANKAR KURRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
272 BENEDICT AVE, NORWALK, OH 44857-2374
(419) 668-8101
(419) 660-2686
Mailing address
272 BENEDICT AVE, NORWALK, OH 44857-2374
(419) 668-8101
(419) 660-2686
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01047100
IN
207P00000X
Emergency Medicine Physician
35-092212
OH
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
35-092212
OH
208M00000X
Hospitalist Physician
Primary
35-092212
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000581380
ANTHEM
OH
05
—
200174730
—
IN
05
—
2871398
—
OH
Enumeration date
07/14/2006
Last updated
07/01/2015
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