Individual
JUSTIN K KRUEGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 COLEMANS CROSSING BOULEVARD, SUITE 210, MARYSVILLE, OH 43040-0000
(937) 644-1441
(937) 642-7760
Mailing address
140 COLEMANS CROSSING BOULEVARD, SUITE 210, MARYSVILLE, OH 43040-0000
(937) 644-1441
(937) 642-7760
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35082295
OH
208000000X
Pediatrics Physician
35082295
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2545044
—
OH
Enumeration date
04/24/2006
Last updated
03/22/2017
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