MEDICARE: DR. MICHAEL CHRISTOPHER KRAFT M.D.

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	207QS0010X	Sports Medicine (Family Medicine) Physician	MD452208	PA
2	207Q00000X	Family Medicine Physician	MT198929	PA
3	207QS0010X	Sports Medicine (Family Medicine) Physician	72374	GA

General Provider Information

NPI Number	:	1558657080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL CHRISTOPHER KRAFT M.D.

Provider Business Mailing Address
First Line	:	993 JOHNSON FERRY RD STE F210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1688
Country	:	US
Telephone Number	:	404-256-1727
Fax Number	:

Provider Business Practice Location Address
First Line	:	993 JOHNSON FERRY RD STE F210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1688
Country	:	US
Telephone Number	:	404-256-1727
Fax Number	:	404-242-3591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	01/29/2024

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