Kreckman, Susan H

Kreckman, Susan H is an individual health care provider with primary practice located at 2817 New Pinery Rd. Divine Savior Healthcare, Inc., Portage WI 53901-0387. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Kreckman, Susan H can be contacted via phone (608) 745-4598.

Contact Information

Primary practice address
2817 New Pinery Rd. Divine Savior Healthcare, Inc. Portage WI 53901-0387
Phone: (608) 745-4598
Fax: (608) 745-6242
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 39356 Wisconsin

Profile Details

NPI number 1376527002
LBN Legal business name Kreckman, Susan H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Oct 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376527002 NPPES
Wisconsin MEDICAID 32379600

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