Provider Demographics
NPI:1902821697
Name:KRUEGER, ANDREW HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HOWARD
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:50 HOSPITAL DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5248
Practice Address - Country:US
Practice Address - Phone:828-654-6015
Practice Address - Fax:828-687-6058
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100395208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89130RTMedicaid
NCP00958842OtherRR MEDICARE
NC130RTOtherBLUE CROSS BLUE SHIELD
NC2294096CMedicare PIN
NCH51970Medicare UPIN
NC2294096CMedicare PIN