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General NPI Number Information
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NPI Number | 1073504692
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Entity Type | Individual
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Provider Name | MICHAEL J JURENOVICH DO
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 59 W MAIN ST STE B
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City | GREENVILLE
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State | PA
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Zip | 16125-2449
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Country | US
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Telephone | 724-588-4805
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Fax | 724-588-4809
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Provider Business Mailing Address
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Address Line | 59 W MAIN ST STE B
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City | GREENVILLE
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State | PA
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Zip | 16125-2449
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Country | US
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Telephone | 724-588-4805
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Fax | 724-588-4809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS 005476L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 34. 003706
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License Number State | OH
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