Individual
JONATHAN DAVID KRAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 QUEENS RD STE 430, CHARLOTTE, NC 28204-3579
(980) 302-6700
(980) 302-6705
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
201702618
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
2017-02618
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000612758
ANTHEM
KY
05
—
64130032
—
KY
Enumeration date
07/12/2006
Last updated
06/05/2024
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