Provider Demographics
NPI:1356516298
Name:KRUG, DAVID KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KENNETH
Last Name:KRUG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 4196
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31914-0196
Mailing Address - Country:US
Mailing Address - Phone:301-279-4490
Mailing Address - Fax:301-279-4489
Practice Address - Street 1:1145 19TH ST NW
Practice Address - Street 2:SUITE 205
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3701
Practice Address - Country:US
Practice Address - Phone:301-279-4490
Practice Address - Fax:301-279-4489
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1282262085R0202X
GA883342085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology