Provider Demographics
NPI:1114959350
Name:STURTZ, KRAIG W (MD)
Entity Type:Individual
Prefix:DR
First Name:KRAIG
Middle Name:W
Last Name:STURTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1703 INNOVATION DRIVE
Mailing Address - Street 2:CLINICAL LAB, LOWER LEVEL
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-8815
Mailing Address - Country:US
Mailing Address - Phone:717-843-8623
Mailing Address - Fax:717-849-5382
Practice Address - Street 1:1703 INNOVATION DRIVE
Practice Address - Street 2:CLINICAL LAB, LOWER LEVEL
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-8815
Practice Address - Country:US
Practice Address - Phone:717-843-8623
Practice Address - Fax:717-849-5382
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053653L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG15591Medicare UPIN
PA801392GX1Medicare ID - Type UnspecifiedMC PROVIDER NUMBER