Provider Demographics
NPI:1477638526
Name:KRIGER, JERALD A (DPM)
Entity Type:Individual
Prefix:DR
First Name:JERALD
Middle Name:A
Last Name:KRIGER
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 1:8605 SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4583
Mailing Address - Country:US
Mailing Address - Phone:703-330-4450
Mailing Address - Fax:703-330-4855
Practice Address - Street 1:8605 SUDLEY RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4583
Practice Address - Country:US
Practice Address - Phone:703-330-4450
Practice Address - Fax:703-330-4855
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000268213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA035461OtherANTHEM BLUE SHIELD OF VA
21906OtherONENET
21906OtherMDIPA
21906OtherUNITEDHEALTHCARE
VA480888469OtherMEDICARE RR
VA009300627Medicaid
71340001OtherCAREFIRST
VAT21757Medicare UPIN
VA480888469Medicare ID - Type Unspecified
21906OtherMDIPA
21906OtherUNITEDHEALTHCARE
VAC05858Medicare PIN