MEDICARE: KENT KULOW PA-C

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
1	363A00000X	Physician Assistant	50001232	OH

General Provider Information

NPI Number	:	1346256021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENT KULOW PA-C

Provider Business Mailing Address
First Line	:	20800 HARVARD RD
Second Line	:	2ND FLOOR
City	:	HIGHLAND HILLS
State	:	OH
Zip	:	44122-7249
Country	:	US
Telephone Number	:	216-383-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	3909 ORANGE PL
Second Line	:	SUITE 2100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4478
Country	:	US
Telephone Number	:	216-896-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	11/13/2015

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Directions to “ KENT KULOW PA-C” Practice Location

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