Provider Demographics
NPI:1174529879
Name:KREGER, HOWARD LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:LAWRENCE
Last Name:KREGER
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 MEDICAL PARK DR
Practice Address - Street 2:STE 202
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1902
Practice Address - Country:US
Practice Address - Phone:704-403-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-034222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254926300Medicaid
FL1037146OtherCARE PLUS
FL152272OtherWELLCARE/STAYWELL
FL285343OtherAVMED
FLG73901OtherVISTA
FL0986082OtherCIGNA
FL3001543OtherGHI
FL400000966000OtherPREFERRED CARE PARTNERS
FL254926300Medicaid
FL130025178OtherRAILROAD MEDICARE
FL42980OtherBLUE CROSS BLUE SHIELD
FL41034OtherNHP
FL41034OtherNHP
FL254926300Medicaid