Individual
IHOR ALEXANDER KRYNYCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
829 N CENTER AVE, SUITE 260, GAYLORD, MI 49735-1595
(989) 731-7729
(989) 731-7983
Mailing address
829 N CENTER AVE, SUITE 260, GAYLORD, MI 49735-1595
(989) 731-7729
(989) 731-7983
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301060478
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406910201
BCBSM PROVIDER NUMBER
MI
01
—
11383155
CAQH PROVIDER ID
—
05
—
4605008
—
MI
01
—
DA0074
MEDICARE RR PROV ID
—
Enumeration date
07/05/2006
Last updated
01/18/2008
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