Provider Demographics
NPI:1982230173
Name:KRIEGER, MAX
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:KRIEGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6942 TYLERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1511
Mailing Address - Country:US
Mailing Address - Phone:513-868-0055
Mailing Address - Fax:513-297-7577
Practice Address - Street 1:6942 TYLERSVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1511
Practice Address - Country:US
Practice Address - Phone:513-868-0055
Practice Address - Fax:513-297-7577
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator