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Individual

DR. SHANE H KRUITBOSCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4165 TWIN FALLS DR, RENO, NV 89511
(775) 348-1313
(775) 348-1798
Mailing address
18124 WEDGE PKWY # 933, RENO, NV 89511-8134
(775) 742-0734

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10083
NV
207L00000X
Anesthesiology Physician
C134131
CA
207L00000X
Anesthesiology Physician
K9827
TX
207L00000X
Anesthesiology Physician
MD207244
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2016072
NV
Enumeration date
06/03/2006
Last updated
02/05/2022
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