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NPI Code Detail

MEDICARE: MARYANN KUZMA MD

MEDICARE:   MARYANN  KUZMA  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD034433EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083662308
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANN KUZMA MD
Provider Business Mailing Address
First Line : 1601 CHERRY ST
Second Line : SUITE 11511
City : PHILADELPHIA
State : PA
Zip : 19102-1321
Country : US
Telephone Number : 215-255-7822
Fax Number : 215-255-7825
Provider Business Practice Location Address
First Line : 2126 FAIRMOUNT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-2603
Country : US
Telephone Number : 215-236-4600
Fax Number : 215-236-4609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2006
Last Update Date : 10/03/2012

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