Healthcare Provider Details

I. General information

NPI: 1003498254
Provider Name (Legal Business Name): SAUMIA KURUVILLA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAUMIA THOMAS DO

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 COLONEL GLENN HWY
DAYTON OH
45435-0001
US

IV. Provider business mailing address

3640 COLONEL GLENN HWY STUDENT UNION 053
DAYTON OH
45435-0001
US

V. Phone/Fax

Practice location:
  • Phone: 937-775-3407
  • Fax:
Mailing address:
  • Phone: 937-775-3407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number34.016813
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: