Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301052958 | MI |
N | 111NI0900X | Internist | 4301052958 | MI |
N | 207RH0000X | Hematologist | 4301052958 | MI |
N | 207RH0003X | Hematology & Oncology | 052958 | MI |
Y | 207RX0202X | Medical Oncology | 4301052958 | MI |
NPI | 1396745014 |
---|---|
Provider Name | John C Krauss |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 01/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3425471 | (05) | MI |
F22538 | (02) | MI |