Healthcare Provider Details

I. General information

NPI: 1518944370
Provider Name (Legal Business Name): JOHN RAVI KURIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PORTERS COVE RD
HINGHAM MA
02043-1026
US

IV. Provider business mailing address

15 PORTERS COVE RD
HINGHAM MA
02043-1026
US

V. Phone/Fax

Practice location:
  • Phone: 781-740-4340
  • Fax:
Mailing address:
  • Phone: 781-740-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number71436
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: