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:
Health care specialties
| Specialty | Code | License # | 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 13th, 2026 - about 4 months 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 | 1114917226 | NPPES |
| Michigan | MEDICAID | 4695097 |
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