Individual
DR. CHANTAL COUSINEAU-KRIEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
59TH MEDICAL WINGE GE, 2200 BERGQUIST DRIVE STE 1, LACKLAND AFB, TX 78236-9908
(240) 505-2613
Mailing address
1050W PERIMETER RD, JB ANDREWS, MD 20762-6601
(240) 587-4928
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01061283A
IN
390200000X
Student in an Organized Health Care Education/Training Program
101061283A
IN
Other
Enumeration date
09/22/2005
Last updated
08/14/2015
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