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General NPI Number Information
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NPI Number | 1962798231
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Entity Type | Individual
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Provider Name | CHAD KRITZBERGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 10/12/2019
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Provider Practice Location Address
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Address Line | 2509 COUNTY HIGHWAY I
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729
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Country | US
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Telephone | 715-723-9138
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Fax |
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Provider Business Mailing Address
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Address Line | 2164 EDGEVIEW DR
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City | HUDSON
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State | OH
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Zip | 44236-1825
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Country | US
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Telephone | 507-884-5574
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 62568
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License Number State | WI
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