Healthcare Provider Details

I. General information

NPI: 1063099596
Provider Name (Legal Business Name): MAX KRALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE STREET WHITE BUILDING, 5TH FLOOR
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

3400 SPRUCE STREET WHITE BUILDING, 5TH FLOOR
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-2792
  • Fax:
Mailing address:
  • Phone: 215-662-2792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD495297
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: