Basic Information
| Provider Information | |||||||||
| NPI: | 1104454685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRUG | ||||||||
| FirstName: | AMELIA | ||||||||
| MiddleName: | SCHUSTER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 PARK AVE SOUTH | ||||||||
| Address2: | HENNEPIN COUNTY MEDICAL CENTER - EMIM DEPT. | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554151829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128733000 | ||||||||
| FaxNumber: | 6129044358 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 PARK AVE SOUTH | ||||||||
| Address2: | HENNEPIN COUNTY MEDICAL CENTER - EMIM DEPT. | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554151829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6128733000 | ||||||||
| FaxNumber: | 6129044358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2020 | ||||||||
| LastUpdateDate: | 05/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | MN | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.