MEDICARE: DR. MARGARET ELIZABETH KRUK MD

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
1	207Q00000X	Family Medicine Physician	4301086720	MI

General Provider Information

NPI Number	:	1356574727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET ELIZABETH KRUK MD

Provider Business Mailing Address
First Line	:	306 ARBANA DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-3706
Country	:	US
Telephone Number	:	917-969-4405
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 ARBANA DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-3706
Country	:	US
Telephone Number	:	917-969-4405
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2009
Last Update Date	:	09/01/2009

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