Provider Demographics
NPI:1962803817
Name:KRONENBUERGER, MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:KRONENBUERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 MCELDERRY ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2226
Mailing Address - Country:US
Mailing Address - Phone:410-502-6198
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:MEYER 6-181B, DIV OF MOVEMENT DISORDERS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-2226
Practice Address - Country:US
Practice Address - Phone:410-502-0133
Practice Address - Fax:410-502-6737
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital