Individual
MARK THOMAS KRUPP II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5127
Mailing address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5127
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5151013994
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5151013994
STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
06/11/2019
Last updated
06/11/2019
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