Provider Demographics
NPI:1386778413
Name:KROLL, NATALIE L (DO)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:L
Last Name:KROLL
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Gender:F
Credentials:DO
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Mailing Address - Street 1:4401 N CAMPUS RIDGE DR
Mailing Address - Street 2:SUITE B2200
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6112
Mailing Address - Country:US
Mailing Address - Phone:989-837-9400
Mailing Address - Fax:989-837-9410
Practice Address - Street 1:4401 N CAMPUS RIDGE DR
Practice Address - Street 2:SUITE B2200
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6112
Practice Address - Country:US
Practice Address - Phone:989-837-9400
Practice Address - Fax:989-837-9410
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2012-02-28
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Provider Licenses
StateLicense IDTaxonomies
MI5101016327207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI114766500Medicaid