Individual
DR. VARUGHESE KURUVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5400 OLD COURT RD, SUITE 208, RANDALLSTOWN, MD 21133-5100
(410) 561-0737
Mailing address
5401 OLD COURT RD, ATTN: CREDENTIALING, RANDALLSTOWN, MD 21133-5103
(410) 601-5524
(410) 601-8946
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D23628
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20039228
R/R MEDICARE PROVIDER #
MD
01
—
CN6601
R/R MEDICARE GROUP #
MD
Enumeration date
03/29/2006
Last updated
11/29/2007
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