Individual
ROGER JOHN KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2865 N REYNOLDS RD, STE 130, TOLEDO, OH 43615-2068
(419) 578-7036
(419) 537-5597
Mailing address
2865 N REYNOLDS RD, STE 130, TOLEDO, OH 43615-2068
(419) 578-7036
(419) 537-5597
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35043625
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080190310
RRMC
OH
05
—
2048386
—
OH
01
—
KR0473103
MEDICARE
OH
Enumeration date
06/24/2005
Last updated
11/03/2023
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