Provider Demographics
NPI:1437103389
Name:KURUP, SHREE K (MD)
Entity Type:Individual
Prefix:
First Name:SHREE
Middle Name:K
Last Name:KURUP
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 1:11100 EUCLID AVE DEPARTMENT OF OPHTHALMOLOGY UH
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106
Mailing Address - Country:US
Mailing Address - Phone:216-844-3601
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:520-742-7444
Practice Address - Fax:520-297-2267
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52816207WX0107X
OH35.134993207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC147CWOtherBCBS
MO201517109Medicaid
NC811576OtherPARTNERS
VA1437103389Medicaid
AZ411707Medicaid
TN4121520OtherBCBS
SCQ97008Medicaid
NC202290OtherMEDCOST
AR161291001Medicaid
MS06271811Medicaid
TN3337015Medicaid
WV3810004127Medicaid
NC5907909Medicaid
NC2072373Medicare PIN
NC147CWOtherBCBS
MS06271811Medicaid