Kruggel, Ellen Marie

Kruggel, Ellen Marie is an individual health care provider with primary practice located at 4600 Breton Rd Se Suite 103, Kentwood MI 49508-5262. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kruggel, Ellen Marie can be contacted via phone (616) 656-8600.

Contact Information

Primary practice address
4600 Breton Rd Se Suite 103 Kentwood MI 49508-5262
Phone: (616) 656-8600
Fax: (616) 656-8601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301067448 Michigan

Profile Details

NPI number 1114917226
LBN Legal business name Kruggel, Ellen Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Jul 8th, 2007 - about 19 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 1114917226 NPPES
Michigan MEDICAID 4695097

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