Provider Demographics
NPI:1992799407
Name:KUROSE, G ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:G ALAN
Middle Name:
Last Name:KUROSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY
Practice Address - Street 2:BUILDING 4
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-435-3400
Practice Address - Fax:401-435-3586
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD07924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI710041401OtherCIGNA
RI04-00514OtherUNITED HEALTH CARE
RI050483739OtherHEALTH NET / TRI CARE
RI2029351OtherHEALTH CARE VALUE MGT
RI7003046Medicaid
RI709004046OtherMEDICARE GROUP
RI201992OtherBLUE CHIP
RI23669OtherNEIGHBORHOOD HEALTH PLAN
RI65117OtherHARVARD HEALTH PLAN
RI050483739OtherGREAT WEST HEALTH CARE
RIP00249679OtherRAILROAD MEDICARE
RI12011210OtherMULTIPLAN
RI20250-5OtherBCBS OF RI
RI404481OtherTUFTS HEALTH PLAN
RI050483739OtherTIN #
RI23669OtherNEIGHBORHOOD HEALTH PLAN
RIF06354Medicare UPIN