Healthcare Provider Details

I. General information

NPI: 1962645911
Provider Name (Legal Business Name): SHWETA KURIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9103 FRANKLIN SQUARE DR HARRY AND JEANETTE WEINBERG CANCER INSTITUE, 2ND FLOOR
BALTIMORE MD
21237-3900
US

IV. Provider business mailing address

9103 FRANKLIN SQUARE DR HARRY AND JEANETTE WEINBERG CANCER INSTITUE, 2ND FLOOR
BALTIMORE MD
21237-3900
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-7147
  • Fax:
Mailing address:
  • Phone: 443-777-7147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD78748
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: