Healthcare Provider Details

I. General information

NPI: 1780605873
Provider Name (Legal Business Name): MICHAEL ANDREW KREW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 TUSCARAWAS ST W STE 300
CANTON OH
44708-4694
US

IV. Provider business mailing address

2600 SIXTH STREET SW AULTMAN HOSPITAL
CANTON OH
44710
US

V. Phone/Fax

Practice location:
  • Phone: 330-363-6296
  • Fax:
Mailing address:
  • Phone: 330-452-9911
  • Fax: 330-588-4717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35OS3473
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number53473
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: