Provider Demographics
NPI:1699713610
Name:KRUG, ESTHER I (MD)
Entity type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:I
Last Name:KRUG
Suffix:
Gender:
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 64264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4264
Mailing Address - Country:US
Mailing Address - Phone:410-558-5238
Mailing Address - Fax:
Practice Address - Street 1:2435 W BELVEDERE AVE
Practice Address - Street 2:SUITE 56
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5224
Practice Address - Country:US
Practice Address - Phone:410-601-5961
Practice Address - Fax:410-601-9390
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059273207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD110245394OtherR/R MEDICARE PROVIDER #
MD510109300Medicaid
MD07708152/01Medicaid
MDCC3778OtherR/R MEDICARE GROUP #
MDS578E731Medicare PIN
MD110245394OtherR/R MEDICARE PROVIDER #
MD173561ZAC3Medicare PIN