Provider Demographics
NPI:1841635497
Name:THOMAS-KURUVILLA, ROHIT (MD)
Entity type:Individual
Prefix:
First Name:ROHIT
Middle Name:
Last Name:THOMAS-KURUVILLA
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 1:1510 WESTWOOD DR APT 52
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7827
Mailing Address - Country:US
Mailing Address - Phone:313-896-6560
Mailing Address - Fax:
Practice Address - Street 1:2727 PLAZA DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4129
Practice Address - Country:US
Practice Address - Phone:715-847-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2021-12-21
Deactivation Date:2014-03-27
Deactivation Code:
Reactivation Date:2014-05-09
Provider Licenses
StateLicense IDTaxonomies
MN.207RR0500X
WI76032-20207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology