Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD458817 | PA |
N | 207PP0204X | Pediatric Emergency Physician | MD458817 | PA |
NPI | 1588009633 |
---|---|
Provider Name | Dr. Samuel Krass |
First Address | Lansdale, PA 19446-1259 |
Second Address | Lansdale, PA 19446-1259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2013 |
Last Update Date | 18/12/2019 |