Individual
ALLAN N KRUTCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6619 N WICKHAM RD, MELBOURNE, FL 32940
(321) 259-9500
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 446-5941
(706) 721-9286
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME131606
FL
207RH0003X
Hematology & Oncology Physician
Primary
080751
GA
207RX0202X
Medical Oncology Physician
MA34594
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2947005
—
NJ
Enumeration date
03/31/2006
Last updated
07/05/2018
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