Healthcare Provider Details

I. General information

NPI: 1235709551
Provider Name (Legal Business Name): SHYAM KURIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

V. Phone/Fax

Practice location:
  • Phone: 410-929-2792
  • Fax:
Mailing address:
  • Phone: 443-997-2663
  • Fax: 443-997-2663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberD0106446
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: