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Individual

DR. SHANE ARTHUR KRASKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2769 HEARTLAND DRIVE, SUITE 105, CORALVILLE, IA 52241
(319) 545-7310
(319) 545-7314
Mailing address
2771 OAKDALE BLVD STE 3, CORALVILLE, IA 52241-9747
(319) 545-7310
(319) 626-7314

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
33735
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0253070
IA
05
1253070
IA
01
19402
BLUE CROSS BLUE SHIELD
IA
05
2253070
IA
01
30171
BLUE CROSS BLUE SHIELD
IA
01
44526
BLUE CROSS BLUE SHIELD
IA
01
44527
BLUE CROSS BLUE SHIELD
IA
Enumeration date
05/27/2006
Last updated
04/27/2021
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