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NPI Code Detail

MEDICARE: DR. JAMES A KROEZE DO

MEDICARE: DR. JAMES A KROEZE DO
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
1207Q00000XFamily Medicine Physician5101012762MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180176004OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2270381199OTHERMIGROUP TAX ID
301-31294OTHERMIPHP
4085110106OTHERMIBLUE CROSS
51538397120OTHERMIGROUP NPI
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
75460964OTHERMICIGNA

General Provider Information

NPI Number : 1275562696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES A KROEZE DO
Provider Business Mailing Address
First Line : 9625 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9559
Country : US
Telephone Number : 269-465-6050
Fax Number : 269-465-3134
Provider Business Practice Location Address
First Line : 9625 RED ARROW HWY
Second Line :
City : BRIDGMAN
State : MI
Zip : 49106-9559
Country : US
Telephone Number : 269-465-6050
Fax Number : 269-465-3134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 03/07/2023

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Directions to “ DR. JAMES A KROEZE DO” Practice Location

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