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NPI Code Detail

MEDICARE: DR. CHARLES EDWARD KRAUSE M.D.

MEDICARE:  DR. CHARLES EDWARD KRAUSE  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
1207Q00000XFamily Medicine PhysicianMD00020631WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00297263OTHERWARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10206593OTHERWADEPT OF L AND I
2611588400OTHERWAEEOICP

General Provider Information

NPI Number : 1609976208
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES EDWARD KRAUSE M.D.
Provider Business Mailing Address
First Line : 750 SWIFT BLVD
Second Line : SUITE 22
City : RICHLAND
State : WA
Zip : 99352-3521
Country : US
Telephone Number : 509-946-2340
Fax Number : 509-946-2350
Provider Business Practice Location Address
First Line : 750 SWIFT BLVD
Second Line : SUITE 22
City : RICHLAND
State : WA
Zip : 99352-3521
Country : US
Telephone Number : 509-946-2340
Fax Number : 509-946-2350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2006
Last Update Date : 04/26/2011

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Directions to “ DR. CHARLES EDWARD KRAUSE M.D.” Practice Location

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