Provider Demographics
NPI:1801811971
Name:KRUGER, MICHAEL STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:KRUGER
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1720 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4940
Practice Address - Country:US
Practice Address - Phone:701-234-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9822207Q00000X
MN48478207Q00000X
WI49109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01-22323OtherMEDICA
MN016670700Medicaid
MN041D6KROtherBCBS MN
ND13507Medicaid
ND28340OtherBCBS ND
P00413961OtherRR MEDICARE
01-22323OtherMEDICA
MN041D6KROtherBCBS MN
ND712511Medicare PIN
NDN719919Medicare PIN