Basic Information
| Provider Information | |||||||||
| NPI: | 1699745992 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SZURKUS | ||||||||
| FirstName: | DENNIS | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 601372 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282601372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044461544 | ||||||||
| FaxNumber: | 7044461550 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 S KINGS DR | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282072134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044461544 | ||||||||
| FaxNumber: | 7044461550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2006 | ||||||||
| LastUpdateDate: | 03/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 33885 | TN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | ME100440 | FL | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 2014-02175 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1699745992 | 05 | NC | MEDICAID | NC2280 | 05 | SC | MEDICAID | 000142200 | 05 | FL | MEDICAID |