Individual
KENNETH R KRUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5308 HARROUN RD, SUITE 055, SYLVANIA, OH 43560-2114
(419) 824-6599
(419) 885-3870
Mailing address
5308 HARROUN RD, SUITE 055, SYLVANIA, OH 43560-2114
(419) 824-6599
(419) 885-3870
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35046209
OH
207RH0003X
Hematology & Oncology Physician
4301079387
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0560290
—
OH
01
—
KR0586193
MEDICARE
OH
01
—
P00812603
RRMC
OH
Enumeration date
07/01/2005
Last updated
05/01/2012
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