Provider Demographics
NPI:1063419869
Name:KURLANSKI, MICHELE N (DPM)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:N
Last Name:KURLANSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7701
Mailing Address - Country:US
Mailing Address - Phone:207-774-0028
Mailing Address - Fax:207-774-0063
Practice Address - Street 1:23 SPRING ST
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7701
Practice Address - Country:US
Practice Address - Phone:207-774-0028
Practice Address - Fax:207-774-0063
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD1047213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME029282000Medicaid
ME5351860001Medicare NSC
MEU71993Medicare UPIN
ME029282000Medicaid