Individual
DR. COREY JOHN KROETSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12072
ND
208600000X
Surgery Physician
RL10258
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16491
—
ND
Enumeration date
06/26/2008
Last updated
02/27/2025
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