Provider Demographics
NPI:1558337436
Name:KRUGER, MICHAEL P (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:KRUGER
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 1:673 COTTAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3033
Mailing Address - Country:US
Mailing Address - Phone:860-242-9910
Mailing Address - Fax:
Practice Address - Street 1:673 COTTAGE GROVE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3033
Practice Address - Country:US
Practice Address - Phone:860-242-9910
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025963207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010025963CT07OtherANTHEM PROVIDER NUMBER
CT025963OtherSTATE SURGEONS LICENSE
CT3411847OtherAETNA PROVIDER NUMBER
CTP504148OtherOXFORD PROVIDER NUMBER
CT1504531005OtherCIGNA PROVIDER NUMBER
CT000000030194OtherWELLCARE PROVIDER NUMBER
CT14894OtherCONTROLLED SUBSTANCE REG
CT0940200OtherUNITED HEALTHCARE PROVIDE
CT2V5415OtherHEALTHNET PROVIDER NUMBER
CT2V5415OtherHEALTHNET PROVIDER NUMBER
CT3411847OtherAETNA PROVIDER NUMBER