Provider Demographics
NPI:1992026439
Name:BERTRAM, KRAIG EDWARD II (DO)
Entity Type:Individual
Prefix:DR
First Name:KRAIG
Middle Name:EDWARD
Last Name:BERTRAM
Suffix:II
Gender:M
Credentials:DO
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Mailing Address - Street 1:501 S SANTA FE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4189
Mailing Address - Country:US
Mailing Address - Phone:785-825-2273
Mailing Address - Fax:785-825-2275
Practice Address - Street 1:501 S SANTA FE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4189
Practice Address - Country:US
Practice Address - Phone:785-825-2273
Practice Address - Fax:785-825-2275
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2020-03-16
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Provider Licenses
StateLicense IDTaxonomies
KS05-36706208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201077750BMedicaid