Provider Demographics
NPI:1417954447
Name:KRUGER, FREDERICK JULIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JULIAN
Last Name:KRUGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 E. HERNDON AVENUE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2990
Mailing Address - Country:US
Mailing Address - Phone:559-447-9040
Mailing Address - Fax:559-447-9042
Practice Address - Street 1:530 E. HERNDON AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2990
Practice Address - Country:US
Practice Address - Phone:559-447-9040
Practice Address - Fax:559-447-9042
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2782213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11466Medicare UPIN
CA000E27820Medicare ID - Type Unspecified