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General NPI Number Information
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NPI Number | 1447067418
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Entity Type | Organization
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Legal Business Name | AJIT P. KURUVILLA M.D., LLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 299 HURLEY AVE
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City | ROCKVILLE
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State | MD
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Zip | 20850-3118
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Country | US
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Telephone | 301-762-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 8129 HUNTFIELD DR
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City | FULTON
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State | MD
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Zip | 20759-2104
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Country | US
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Telephone | 301-758-9697
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | AJIT PHILIP KURUVILLA
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Credential | MD
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Telephone | 301-758-9697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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