Healthcare Provider Details

I. General information

NPI: 1043506660
Provider Name (Legal Business Name): MARGARET SHAYNE KRUEGER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 DAUPHIN ST STE 2A
MOBILE AL
36608-1763
US

IV. Provider business mailing address

3715 DAUPHIN ST STE 2A CWEB 100, SUITE A
MOBILE AL
36608-1763
US

V. Phone/Fax

Practice location:
  • Phone: 251-344-5265
  • Fax: 251-316-3988
Mailing address:
  • Phone: 251-344-5265
  • Fax: 251-316-3988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1344
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: