Provider Demographics
NPI:1417939711
Name:KURZ, LAWRENCE T (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:T
Last Name:KURZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26025 LAHSER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2601
Mailing Address - Country:US
Mailing Address - Phone:248-663-1900
Mailing Address - Fax:248-663-1902
Practice Address - Street 1:26025 LAHSER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2601
Practice Address - Country:US
Practice Address - Phone:248-663-1900
Practice Address - Fax:248-663-1902
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053442207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3161266Medicaid
MI0767220001OtherADMINISTAR FEDERAL
MI0F31114OtherBCBS
MI0F335830OtherBCBS DME
MI0F335830OtherBCBS DME
MI0M08420004Medicare PIN