Individual
MICHAEL D KRAUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 S CREASY LN, SUITE 120, LAFAYETTE, IN 47905-7438
(765) 447-4165
(765) 447-5939
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
01037755A
IN
208D00000X
General Practice Physician
01037755A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382416
ANTHEM PROVIDER NUMBER
IN
05
—
200536400
—
IN
Enumeration date
10/05/2005
Last updated
06/15/2020
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