MEDICARE: DANIEL E KRACH MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1326222480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL E KRACH MD PC

Provider Business Mailing Address
First Line	:	2510 E DUPONT RD STE 128
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1603
Country	:	US
Telephone Number	:	260-489-4656
Fax Number	:	260-489-8280

Provider Business Practice Location Address
First Line	:	2510 E DUPONT RD STE 128
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-1603
Country	:	US
Telephone Number	:	260-489-4656
Fax Number	:	260-489-8280

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL E KRACH
Credential	:	M.D.
Telephone Number	:	260-489-4656

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	08/23/2023

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