Healthcare Provider Details

I. General information

NPI: 1801094412
Provider Name (Legal Business Name): WILLIAM JOSEPH KROSKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRAMC BLDG 2, ROOM 2J38
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 301-770-2759
  • Fax:
Mailing address:
  • Phone: 301-295-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: