Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | C20004245 | DE |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | C20004245 | DE |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | OS14323 | FL |
NPI | 1063504843 |
---|---|
Provider Name | Dr. Richard W. Kruse |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 07/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001476918 | (05) | PA |
1430611 | (05) | MD |
1476918 | (05) | PA |
1605765 | (05) | NY |
6054102 | (05) | NJ |
6401104 | (05) | VA |
9840787000 | (05) | WV |
F75296 | (02) |