Provider Demographics
NPI:1407834708
Name:KRAUS, DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KRAUS
Suffix:
Gender:M
Credentials:DO
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 636160
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6160
Mailing Address - Country:US
Mailing Address - Phone:800-377-8721
Mailing Address - Fax:
Practice Address - Street 1:718 N MACOMB ST
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-7815
Practice Address - Country:US
Practice Address - Phone:734-240-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.009776207P00000X
MI5101010774207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0756307134OtherBCBS
MI0756307134OtherBCBS
MIE83504Medicare UPIN
MIP00170074Medicare ID - Type UnspecifiedRAILROAD
P40540016Medicare PIN
MIP00060969Medicare ID - Type UnspecifiedRAILROAD
P40010008Medicare PIN
MIQ26294371Medicare ID - Type UnspecifiedPEC OKW (PHYSICIANS)