Provider Demographics
NPI:1972032753
Name:KRUEGER, VAN SCHAUMBURG (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:VAN
Middle Name:SCHAUMBURG
Last Name:KRUEGER
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11330 OLIVE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7149
Mailing Address - Country:US
Mailing Address - Phone:314-782-1994
Mailing Address - Fax:314-948-9010
Practice Address - Street 1:11330 OLIVE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7149
Practice Address - Country:US
Practice Address - Phone:314-782-1994
Practice Address - Fax:314-948-9010
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA184896207X00000X
RIMD18287207X00000X
MO2024000213207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery