Provider Demographics
NPI:1508122284
Name:KRAUSE, DAVID STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STUART
Last Name:KRAUSE
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 1:147 SAWGRASS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3215
Mailing Address - Country:US
Mailing Address - Phone:215-280-9425
Mailing Address - Fax:
Practice Address - Street 1:147 SAWGRASS DRIVE
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-3215
Practice Address - Country:US
Practice Address - Phone:215-280-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021769-E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology