Basic Information
Provider Information
NPI: 1033559018
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRIEGER
FirstName: ANDREW
MiddleName: JOHN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5405 BLUET CT
Address2:  
City: HOLLY SPRINGS
State: NC
PostalCode: 27540
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5405 BLUET CT
Address2:  
City: HOLLY SPRINGS
State: NC
PostalCode: 27540
CountryCode: US
TelephoneNumber: 9898592433
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/05/2013
LastUpdateDate: 12/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X5315075207MIN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X35.125429OHY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X4301109329MIN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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