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Dr. David Edward Kreshek

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NPI Number Detailed Information

Provider Information:

Name: Dr. David Edward Kreshek
Gender: M
Provider License Number If Given: MD0000027537

NPI Information:

NPI: 1609875103
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 5/15/2014

Provider Business Mailing Address:

Address: PO BOX 3727
Johnson City, TN 37602
Phone Number: 4232830776
Fax Number: 4232830549

Provider Business Practice Location Address:

Address: 1009 LARK ST SUITE 2
Johnson City, TN 37604
Phone Number: 4232830776
Fax Number: 4232830549

Provider Taxonomy:

Primary: 207L00000X
Secondary (if any):
State: TN

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