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Individual

DR. KEVIN WURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 E SPRING ST, SUITE 200, NEW ALBANY, IN 47150-2926
(812) 945-7536
(812) 945-7542
Mailing address
700 E SPRING ST, SUITE 200, NEW ALBANY, IN 47150-2926
(812) 945-7536
(812) 945-7542

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01040034A
IN
207P00000X
Emergency Medicine Physician
27132
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100327970A
IN
01
61-1091357
TAX ID
IN
05
64271323
KY
Enumeration date
12/18/2006
Last updated
02/03/2015
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