Provider Demographics
NPI:1669431425
Name:KURYAN, ALEX S (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:S
Last Name:KURYAN
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 1:915 OLD FERN HILL ROAD
Mailing Address - Street 2:BUILDING B SUITE 300
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:610-431-3122
Mailing Address - Fax:610-431-4799
Practice Address - Street 1:915 OLD FERN HILL ROAD
Practice Address - Street 2:BUILDING B SUITE 300
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380
Practice Address - Country:US
Practice Address - Phone:610-431-3122
Practice Address - Fax:610-431-4799
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417718207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101471997001Medicaid
I36182Medicare UPIN
093167Medicare ID - Type Unspecified