Provider Demographics
NPI:1851493969
Name:KRAUS, MARK LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:LAWRENCE
Last Name:KRAUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:714 CHASE PARKWAY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3939
Mailing Address - Country:US
Mailing Address - Phone:203-755-4577
Mailing Address - Fax:203-756-3628
Practice Address - Street 1:714 CHASE PARKWAY
Practice Address - Street 2:SUITE 6
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3939
Practice Address - Country:US
Practice Address - Phone:203-756-4577
Practice Address - Fax:203-756-3628
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2021-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT18376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001183763Medicaid
010018376CT01OtherBCBS
B39608Medicare UPIN
CT110000834Medicare PIN