Provider Demographics
NPI:1023314697
Name:KRUSE, STEVEN GRANT (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GRANT
Last Name:KRUSE
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 1:802 TIMBERLANE
Mailing Address - Street 2:
Mailing Address - City:HUXLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50124-0097
Mailing Address - Country:US
Mailing Address - Phone:515-597-2540
Mailing Address - Fax:515-597-3945
Practice Address - Street 1:802 TIMBERLANE
Practice Address - Street 2:
Practice Address - City:HUXLEY
Practice Address - State:IA
Practice Address - Zip Code:50124-0097
Practice Address - Country:US
Practice Address - Phone:515-597-2540
Practice Address - Fax:515-597-3945
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine