Individual
DR. WAYNE A KRUITHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3770
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3770
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
015000
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275700099
—
ME
Enumeration date
01/23/2006
Last updated
01/10/2013
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