Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Krug, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1164263190

Ethan Krug, MD is a Student in an Organized Health Care Education/Training Program in Burlington, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2024.

Licensed in
MA
In the registry since
2024
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

41 Mall Rd
Burlington, MA 01805-0001
Phone: (781) 744-5100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence 3017222 (MA)

Record details

NPI number1164263190
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 4, 2024
Last updated in NPPESJune 4, 2024
Certification dateJune 4, 2024
Mailing address10 Roberts St Apt 15, Somerville, MA 02145-2552

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