Provider Demographics
NPI:1497739171
Name:KURUC, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:KURUC
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 1:2196 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2405
Mailing Address - Country:US
Mailing Address - Phone:740-264-0111
Mailing Address - Fax:740-346-0511
Practice Address - Street 1:2196 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2405
Practice Address - Country:US
Practice Address - Phone:740-264-0111
Practice Address - Fax:740-346-0511
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350-45513207R00000X
OH35045513207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0545315Medicaid
OH110010252OtherRAILROAD MEDICARE
OHA80409Medicare UPIN
OH0515874Medicare PIN
OH0515875Medicare PIN