Provider Demographics
NPI:1043295330
Name:KURIC, JOAN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:MARIE
Last Name:KURIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 RIDGE RD
Mailing Address - Street 2:STE. G
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1726
Mailing Address - Country:US
Mailing Address - Phone:219-836-2113
Mailing Address - Fax:219-836-4068
Practice Address - Street 1:900 RIDGE RD
Practice Address - Street 2:STE. G
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1726
Practice Address - Country:US
Practice Address - Phone:219-836-2113
Practice Address - Fax:219-836-4068
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031879A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN486300Medicare ID - Type Unspecified