Individual
ETHAN KRUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-0001
(781) 744-5100
Mailing address
10 ROBERTS ST APT 15, SOMERVILLE, MA 02145-2552
(347) 852-5831
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
3017222
MA
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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