Healthcare Provider Details
I. General information
NPI: 1881913275
Provider Name (Legal Business Name): GEORGE KURIAN, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2010
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 CRAIN HWY SW SUITE 404
GLEN BURNIE MD
21061-5577
US
IV. Provider business mailing address
10845 PHILADELPHIA RD
WHITE MARSH MD
21162-1717
US
V. Phone/Fax
- Phone: 410-761-4442
- Fax: 410-787-9647
- Phone: 410-335-0008
- Fax: 410-335-3113
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEORGE
KURIAN
Title or Position: OWNER
Credential: M.D.
Phone: 410-335-0008