Basic Information
Provider Information
NPI: 1891042164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEORGE
FirstName: DONNA
MiddleName: KUROWSKI
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KUROWSKI
OtherFirstName: DONNA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 330 MOUNT AUBURN ST
Address2:  
City: CAMBRIDGE
State: MA
PostalCode: 021385502
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 330 MOUNT AUBURN ST
Address2:  
City: CAMBRIDGE
State: MA
PostalCode: 021385502
CountryCode: US
TelephoneNumber: 6174923500
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2012
LastUpdateDate: 08/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X251874MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XMD458083PAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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