Individual
JONATHAN KRAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 N EDDY ST, DEPARTMENT OF RADIOLOGY, SOUTH BEND, IN 46617-2808
(574) 204-6209
Mailing address
211 N EDDY ST, DEPARTMENT OF RADIOLOGY, SOUTH BEND, IN 46617-2808
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
28090
SC
2085R0202X
Diagnostic Radiology Physician
Primary
01066925A
IN
2085R0202X
Diagnostic Radiology Physician
2008012506
MO
2085R0202X
Diagnostic Radiology Physician
28090
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200949250
—
IN
Enumeration date
11/01/2006
Last updated
05/31/2022
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