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Individual
ROGER JOHN KRUSE
Active
Individual
ROGER JOHN KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35043625
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080190310
RRMC
OH
05
—
2048386
—
OH
01
—
KR0473103
MEDICARE
OH
Enumeration date
06/24/2005
Last updated
11/03/2023
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