Individual
ROBERT ELROY KRAETSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 MEDICAL PLZ, SUITE 100, LAKE ST LOUIS, MO 63367-1490
(636) 639-8600
(636) 639-8666
Mailing address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(636) 327-1202
(363) 327-1222
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
R6140
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110189320
RR MEDICARE
—
01
—
121347
BCBS
MO
01
—
134622
HEALTHLINK
—
05
—
202536827
—
MO
01
—
3603013
UHC
—
01
—
4000561
AETNA
—
01
—
58811
GHP
—
Enumeration date
04/06/2006
Last updated
08/27/2012
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