Individual
MRS. IDA J KURUVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
7501 RITCHIE HWY, GLEN BURNIE, MD 21061-3716
(410) 766-5220
(410) 760-3634
Mailing address
7501 RITCHIE HWY, GLEN BURNIE, MD 21061-3716
(410) 766-5220
(410) 760-3634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11127
MD
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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