Individual
THOMAS EDMUND KREIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
213 MIDDLEBURY ST, GOSHEN, IN 46528-2956
(574) 534-3300
(574) 534-5412
Mailing address
213 MIDDLEBURY ST, GOSHEN, IN 46528-2956
(574) 534-0088
(574) 534-5412
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01051361
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200249480A
—
IN
Enumeration date
04/19/2006
Last updated
12/31/2020
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