Healthcare Provider Details

I. General information

NPI: 1427788579
Provider Name (Legal Business Name): DR. PATRICK SEAN KROENUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE RD STE 742
ROYAL OAK MI
48073-6770
US

IV. Provider business mailing address

3601 W 13 MILE RD OFC
ROYAL OAK MI
48073-6712
US

V. Phone/Fax

Practice location:
  • Phone: 248-551-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301515084
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: