Provider Demographics
NPI:1346225646
Name:KREGER, DAVID L (MD)
Entity Type:Individual
Prefix:PROF
First Name:DAVID
Middle Name:L
Last Name:KREGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 GAINSBOROUGH SQ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1706
Mailing Address - Country:US
Mailing Address - Phone:757-547-0798
Mailing Address - Fax:757-547-0145
Practice Address - Street 1:112 GAINSBOROUGH SQ
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1706
Practice Address - Country:US
Practice Address - Phone:757-547-0798
Practice Address - Fax:757-547-0145
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023966207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA159427OtherBCBS OF VA
VA010103011Medicaid
VA15139OtherSENTARA/OPTIMA
VA55083OtherMAMSI/MDIPA
VI55083OtherUNITEDHEALTHCARE
NC8905994Medicaid
NC8905994Medicaid
VA010103011Medicaid
VA15139OtherSENTARA/OPTIMA