Jeffrey Kreutzberg, DPM

Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Marblehead, OH

NPI 1841684669 · NPPES record last updated Mar 19, 2015

Key facts

NPI
1841684669
Entity type
Individual (NPI type 1)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
36.001863 (OH)
Practice address
1114 Lake St
Marblehead, OH 43440-2034
Phone
(419) 341-9208
NPI assigned
Mar 19, 2015
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

State licenses

LicenseStateTypeSpecialty
36.001863OHMDFoot & Ankle Surgery Podiatrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36.001863 OH Yes

Addresses

Primary practice location

1114 Lake St
Marblehead, OH 43440-2034

Mailing address

1114 Lake St
Marblehead, OH 43440-2034
Phone (419) 341-9208

Other identifiers

IdentifierTypeStateIssuer
0OtherOHNONE

Other providers in Marblehead, OH

All providers in Marblehead, OH · Foot & Ankle Surgery Podiatrist in Ohio

Sources for this page

Verify at the official NPI Registry.