Individual
STEPHEN E KRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 GRAHAM RD, STE 107, FLORISSANT, MO 63031-8077
(314) 837-3667
(314) 837-3728
Mailing address
1150 GRAHAM RD, STE 107, FLORISSANT, MO 63031-8077
(314) 837-3667
(314) 837-3728
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R1PO1
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132586
BLUE CROSS BLUE SHIELD
MO
01
—
180046484
RAILROAD MEDICARE
MO
01
—
1820046484
RAILROAD MEDICARE
MO
05
—
208670323
—
MO
Enumeration date
10/28/2005
Last updated
12/01/2021
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