Provider Demographics
NPI:1326069295
Name:KRATZ, RUEDIGER (MD)
Entity Type:Individual
Prefix:DR
First Name:RUEDIGER
Middle Name:
Last Name:KRATZ
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:855-480-7553
Mailing Address - Fax:717-267-0159
Practice Address - Street 1:755 NORLAND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4221
Practice Address - Country:US
Practice Address - Phone:855-480-7553
Practice Address - Fax:717-267-0159
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420852L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001925460Medicaid
PA066663FLTMedicare PIN
PAC62687Medicare UPIN
PA001925460Medicaid