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General NPI Number Information
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NPI Number | 1861652646
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Entity Type | Organization
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Legal Business Name | KURUP WOUND CARE, INC.
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Dates
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Enumeration Date | 06/14/2008
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 1835 UNIVERSITY BLVD E STE 208
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City | HYATTSVILLE
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State | MD
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Zip | 20783-4600
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Country | US
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Telephone | 301-873-9876
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Fax | 301-445-3502
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Provider Business Mailing Address
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Address Line | 1835 UNIVERSITY BLVD E STE 208
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City | HYATTSVILLE
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State | MD
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Zip | 20783-4600
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Country | US
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Telephone | 301-873-9876
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Fax | 301-445-3502
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | DR. AJIT GOPAL KURUP
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Credential | M.D.
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Telephone | 301-873-9876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0063681
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License Number State | MD
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