Healthcare Provider Details

I. General information

NPI: 1093748949
Provider Name (Legal Business Name): MOUNTAIN VIEW UROLOGICAL, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HOSPITAL DR SUITE 2A
HENDERSONVILLE NC
28792-5248
US

IV. Provider business mailing address

50 HOSPITAL DR SUITE 2A
HENDERSONVILLE NC
28792-5248
US

V. Phone/Fax

Practice location:
  • Phone: 828-654-6015
  • Fax: 828-687-6058
Mailing address:
  • Phone: 828-654-6015
  • Fax: 828-687-6058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW H KRUEGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 828-654-6015