Provider Demographics
NPI:1043506660
Name:KRUEGER, MARGARET SHAYNE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:SHAYNE
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 DAUPHIN ST STE 2A
Mailing Address - Street 2:CWEB 100, SUITE A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1763
Mailing Address - Country:US
Mailing Address - Phone:251-344-5265
Mailing Address - Fax:251-316-3988
Practice Address - Street 1:3715 DAUPHIN ST STE 2A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1763
Practice Address - Country:US
Practice Address - Phone:251-344-5265
Practice Address - Fax:251-316-3988
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1344207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
102I166433Medicare UPIN