Healthcare Provider Details

I. General information

NPI: 1124476759
Provider Name (Legal Business Name): JOSHUA KROPKO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 10/07/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GRAFENWOEHR HEALTH CLINIC
APO AE
09114
US

IV. Provider business mailing address

CMR 415 BOX 5578
APO AE
09114-1056
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number62565
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: