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Individual

ERNEST KRUG

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
1695 W 12 MILE RD, STE. 120, BERKLEY, MI 48072-2182
(248) 691-4744
Mailing address
3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 48073-6712

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
4301060939
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2929992
MI
01
3506314650
BCBSM
MI
Enumeration date
03/25/2006
Last updated
07/08/2007
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