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General NPI Number Information
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NPI Number | 1861646234
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Entity Type | Individual
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Provider Name | PAUL M KRUEGER D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 25 CHESTNUT ST APT 203
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City | HADDONFIELD
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State | NJ
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Zip | 08033-1857
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Country | US
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Telephone | 856-428-7211
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Fax |
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Provider Business Mailing Address
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Address Line | 133 SHORECREST CT
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City | MARCO ISLAND
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State | FL
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Zip | 34145-4140
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Country | US
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Telephone | 856-428-7211
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MB03751100
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License Number State | NJ
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