Healthcare Provider Details

I. General information

NPI: 1760657332
Provider Name (Legal Business Name): BRYAN DAVID KRAFT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 04/17/2025
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV IM PULMONARY
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-8762
  • Fax: 314-454-7524
Mailing address:
  • Phone: 314-454-8762
  • Fax: 314-454-7524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2021026153
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2021026153
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: