Individual
MICHAEL D. KORENMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1821 8TH AVE, FORT WORTH, TX 76110-1304
(817) 927-2329
(817) 924-0177
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 924-0177
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E2661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020054134
RAILROAD MEDICARE
—
05
—
089877703
—
TX
Enumeration date
07/11/2006
Last updated
11/03/2011
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