Bruce R Krygowski, MD
Individual provider Active NPI Plastic and Reconstructive Surgery Physician · Plover, WI
NPI 1790960433 · NPPES record last updated Dec 31, 2007
Key facts
- NPI
- 1790960433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Plastic and Reconstructive Surgery Physician 2086S0122X
- License
- 21353020 (WI)
- Practice address
- 1840 Post Road
Suite 7
Plover, WI 54677-2832 - Phone
- (715) 344-1513
- Fax
- (715) 344-2261
- NPI assigned
- Dec 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221353020 | WI | MD | Surgery of the Hand (Surgery) Physician |
| 21353020 | WI | MD | Plastic and Reconstructive Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 2082S0099X | 21353020 | WI | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 21353020 | WI | Yes |
| Surgery of the Hand (Surgery) Physician | 2086S0105X | WI |
Addresses
Primary practice location
1840 Post Road
Suite 7
Plover, WI 54677-2832
Mailing address
1840 Post Road
Suite 7
Plover, WI 54677-2832
Phone (715) 344-1513
Other providers in Plover, WI
- Nathaniel David Klesmith
- Kerry M Kluck
- Derek Konkol
- Deborah L Kosobucki
- Leah Krueger
- Kathleen Lynnette Kube
- Lynn Kuklinski
- Tiffany L Kula
- Larry Woods, OD
- Kimberley Louise Laube
All providers in Plover, WI · Plastic and Reconstructive Surgery Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.