Healthcare Provider Details

I. General information

NPI: 1073504221
Provider Name (Legal Business Name): ERIC MARSHALL KRAUS M.D, M.S, F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 11/20/2021
Certification Date: 11/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-1000
US

IV. Provider business mailing address

WAKE FOREST BAPTIST MEDICAL CENTER MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-1000
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4161
  • Fax: 336-716-9440
Mailing address:
  • Phone: 336-716-4161
  • Fax: 336-716-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number-26946
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number26946
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: