Provider Demographics
NPI:1740561471
Name:ANDREW V. KRIEGEL, MD, LLC
Entity Type:Organization
Organization Name:ANDREW V. KRIEGEL, MD, LLC
Other - Org Name:AVK PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:V
Authorized Official - Last Name:KRIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-509-0512
Mailing Address - Street 1:2296 OPITZ BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3300
Mailing Address - Country:US
Mailing Address - Phone:703-910-6567
Mailing Address - Fax:703-910-4883
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3300
Practice Address - Country:US
Practice Address - Phone:703-910-6567
Practice Address - Fax:703-910-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty