1962497313 NPI number — DR. FREDERICK GOTTLIEB KURZ MD

Table of content: DR. FREDERICK GOTTLIEB KURZ MD (NPI 1962497313)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962497313 NPI number — DR. FREDERICK GOTTLIEB KURZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KURZ
Provider First Name:
FREDERICK
Provider Middle Name:
GOTTLIEB
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1962497313
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4135 BOARDMAN CANFIELD RD STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANFIELD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44406-9803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-286-5330
Provider Business Mailing Address Fax Number:
330-286-5396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3055 INNOVATION WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERMITAGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16148-7905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-333-5438
Provider Business Practice Location Address Fax Number:
814-333-5439
Provider Enumeration Date:
09/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  35.054131 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: MD435533 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000763676 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0744370 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0014631140005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138639ZB9 . This is a "MEDICARE PTAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000594274 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: P00676829 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com