Provider Demographics
NPI:1780605873
Name:KREW, MICHAEL ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:KREW
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 1:2600 SIXTH STREET SW
Mailing Address - Street 2:AULTMAN HOSPITAL
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710
Mailing Address - Country:US
Mailing Address - Phone:330-452-9911
Mailing Address - Fax:330-588-4717
Practice Address - Street 1:2600 TUSCARAWAS ST W STE 300
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-4694
Practice Address - Country:US
Practice Address - Phone:330-363-6296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35OS3473207V00000X
OH53473207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0628137Medicaid
E76424Medicare UPIN
OH0628137Medicaid