Healthcare Provider Details

I. General information

NPI: 1780679787
Provider Name (Legal Business Name): SOREN R KRAEMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAUREL ST SUITE 2100
DES MOINES IA
50314-3017
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50306-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-247-3266
  • Fax: 515-643-8688
Mailing address:
  • Phone: 515-247-3266
  • Fax: 515-643-8688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number37234
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD-37234
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: