Provider Demographics
NPI:1902977051
Name:KUZMA, GEORGE E (DPM)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:KUZMA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SUSQUEHANNA BLVD
Mailing Address - Street 2:
Mailing Address - City:W HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1118
Mailing Address - Country:US
Mailing Address - Phone:570-459-2000
Mailing Address - Fax:570-459-2002
Practice Address - Street 1:170 SUSQUEHANNA BLVD
Practice Address - Street 2:
Practice Address - City:W HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-1118
Practice Address - Country:US
Practice Address - Phone:570-459-2000
Practice Address - Fax:570-459-2002
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002868L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30565Medicare UPIN
PA461948Medicare ID - Type UnspecifiedMEDICARE #