Healthcare Provider Details

I. General information

NPI: 1801924030
Provider Name (Legal Business Name): TIFFANY DANIELLE KRATZER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY DANIELLE SCHAIBLE MD

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 311
GREENSBORO NC
27401-1210
US

IV. Provider business mailing address

PO BOX 344
WINSTON SALEM NC
27102-0344
US

V. Phone/Fax

Practice location:
  • Phone: 336-272-6161
  • Fax: 336-230-2150
Mailing address:
  • Phone: 336-716-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number127288
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number2008-01160
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: