Provider Demographics
NPI:1841213733
Name:KURUVILLA, ASHOK K (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:K
Last Name:KURUVILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-339-2771
Practice Address - Street 1:40 V TWIN DR
Practice Address - Street 2:SUITE 205
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7875
Practice Address - Country:US
Practice Address - Phone:717-339-2790
Practice Address - Fax:717-339-2771
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD445901207RE0101X
FLME0062275207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102723346Medicaid
PA418792OtherUPMC
FL371525600Medicaid
PA30123102OtherAMERIHEALTH MERCY - WMG
PA1612004OtherGATEWAY
PA30123102OtherAMERIHEALTH MERCY - WMG
PA102723346Medicaid
PA1612004OtherGATEWAY
PA418792OtherUPMC