Individual
DARICK W. KRAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 482-7800
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1801
ME
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
6096
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992181069
—
ME
Enumeration date
07/30/2015
Last updated
03/28/2022
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