Provider Demographics
NPI:1538115134
Name:KREUTTER, FLORY M (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORY
Middle Name:M
Last Name:KREUTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S CHERRY ST STE 410
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1231
Mailing Address - Country:US
Mailing Address - Phone:303-333-3388
Mailing Address - Fax:303-333-5094
Practice Address - Street 1:425 S CHERRY ST STE 410
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1231
Practice Address - Country:US
Practice Address - Phone:303-333-3388
Practice Address - Fax:303-333-5094
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01305952Medicaid
COE30977Medicare UPIN
CO01305952Medicaid