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General NPI Number Information
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NPI Number | 1477073781
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Entity Type | Individual
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Provider Name | MARISSA CHRISTINE KRUGH DO
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Gender | Female
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 800 TILGHMAN DR
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City | DUNN
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State | NC
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Zip | 28334-5510
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Country | US
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Telephone | 910-892-7161
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Fax |
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Provider Business Mailing Address
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Address Line | 8104 PENUCHE WAY
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-3377
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Country | US
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Telephone | 269-462-1076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2019-01151
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2019-01151
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License Number State | NC
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