1437103389 NPI number — SHREE K KURUP M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437103389 NPI number — SHREE K KURUP M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KURUP

Provider First Name:

SHREE

Provider Middle Name:

K

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1437103389

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

01/11/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

11100 EUCLID AVE DEPARTMENT OF OPHTHALMOLOGY UH

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

CLEVELAND

Provider Business Mailing Address State Name:

OH

Provider Business Mailing Address Postal Code:

44106

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

216-844-3601

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

11100 EUCLID AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

CLEVELAND

Provider Business Practice Location Address State Name:

OH

Provider Business Practice Location Address Postal Code:

44106-1716

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

520-742-7444

Provider Business Practice Location Address Fax Number:

520-297-2267

Provider Enumeration Date:

05/22/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207WX0107X , with the licence number:  52816 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207W00000X , with the licence number: 35.134993 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 147CW . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 201517109 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
• Identifier: 811576 . This is a "PARTNERS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 1437103389 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
• Identifier: 411707 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: 4121520 . This is a "BCBS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: Q97008 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
• Identifier: 202290 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 161291001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
• Identifier: 06271811 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
• Identifier: 3337015 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
• Identifier: 3810004127 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
• Identifier: 5907909 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".