Kroetsch, Corey John
Kroetsch, Corey John is an individual health care provider with primary practice located at 801 Broadway N , Fargo ND 58102-3641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Kroetsch, Corey John can be contacted via phone (701) 234-5884.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | RL10258 | North Dakota |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 12072 | North Dakota |
Profile Details
| NPI number | 1194987669 |
|---|---|
| LBN Legal business name | Kroetsch, Corey John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2008 |
| Last updated | Jan 17th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194987669 | NPPES |
| North Dakota | MEDICAID | 16491 |
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