MEDICARE: DR. RAYMOND A HURM M.D.

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	208800000X	Urology Physician	7498	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	787313	OTHER	AZ	WELLCARE MEDICARE ADVANTAGE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P01165312	OTHER	AZ	RAILROAD MCR
3	1803508	OTHER	AZ	CIGNA
4	4022121	OTHER	AZ	AETNA

General Provider Information

NPI Number	:	1356343503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND A HURM M.D.

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	9327 N 3RD ST #204
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2473
Country	:	US
Telephone Number	:	602-944-9679
Fax Number	:	602-944-8471

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/19/2014

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Directions to “ DR. RAYMOND A HURM M.D.” Practice Location

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