Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 2746 | PA |
N | 111NN0400X | Neurology | 7366 | AZ |
NPI | 1679503981 |
---|---|
Provider Name | Dr. George William Kukurin |
First Address | Pittsburgh, PA 15203-2228 |
Second Address | Pittsburgh, PA 15203-2228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T28616 | (02) | PA |