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Individual

GREGORY E KRAUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 GRAND CENTRAL MALL STE 11, VIENNA, WV 26105-4100
(304) 916-1270
(304) 916-1705
Mailing address
118 WAVERLY OAKS LN, WILLIAMSTOWN, WV 26187-7917
(304) 464-4922

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20217
WV
207Y00000X
Otolaryngology Physician
35080785
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1802567000
WV
05
2204144
OH
Enumeration date
03/28/2006
Last updated
05/13/2015
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