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NPI Code Detail

MEDICARE: MR. WILLIAM E KALKREUTH M.ED.

MEDICARE: MR. WILLIAM E KALKREUTH M.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE193OH

General Provider Information

NPI Number : 1073658308
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM E KALKREUTH M.ED.
Provider Business Mailing Address
First Line : 4792 MUNSON ST NW
Second Line : MUNSON PROFESSIONAL CENTRE
City : CANTON
State : OH
Zip : 44718-3630
Country : US
Telephone Number : 330-494-4636
Fax Number : 330-494-5861
Provider Business Practice Location Address
First Line : 4792 MUNSON ST NW
Second Line : MUNSON PROFESSIONAL CENTRE
City : CANTON
State : OH
Zip : 44718-3630
Country : US
Telephone Number : 330-494-4636
Fax Number : 330-494-5861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 07/08/2007

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