Organization
KURUVILLA JOHN, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURUVILLA JOHN M.D. (PRESIDENT)
(304) 767-7880
Entity
Organization
Contact information
Practice address
401 DIVISION ST, SUITE 104, SOUTH CHARLESTON, WV 25309-1455
(304) 767-7880
(304) 767-7885
Mailing address
401 DIVISION ST, SUITE 104, SOUTH CHARLESTON, WV 25309-1455
(304) 767-7880
(304) 767-7885
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
16097
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089936000
—
WV
Enumeration date
01/22/2007
Last updated
08/22/2020
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