Provider Demographics
NPI:1821544149
Name:KURJAKOVIC, INES (MD)
Entity Type:Individual
Prefix:
First Name:INES
Middle Name:
Last Name:KURJAKOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH ST.
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-1921
Mailing Address - Country:US
Mailing Address - Phone:413-447-2839
Mailing Address - Fax:413-447-2839
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-447-2839
Practice Address - Fax:413-447-2839
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA268825207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine