Provider Demographics
NPI:1699745992
Name:SZURKUS, DENNIS C JR (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:C
Last Name:SZURKUS
Suffix:JR
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:PO BOX 601372
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1372
Mailing Address - Country:US
Mailing Address - Phone:704-446-1544
Mailing Address - Fax:704-446-1550
Practice Address - Street 1:1350 S KINGS DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2134
Practice Address - Country:US
Practice Address - Phone:704-446-1544
Practice Address - Fax:704-446-1550
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33885207V00000X
FLME100440207V00000X
NC2014-02175207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1699745992Medicaid
SCNC2280Medicaid
FL000142200Medicaid
SCNC2280Medicaid
NC1699745992Medicaid
FLBI139ZMedicare PIN