MEDICARE: ROBERT A KRAUSE MD, PLLC

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	207Q00000X	Family Medicine Physician	122788	NC

General Provider Information

NPI Number	:	1710932835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT A KRAUSE MD, PLLC

Provider Business Mailing Address
First Line	:	11 OFFICE PARK DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7326
Country	:	US
Telephone Number	:	910-353-9906
Fax Number	:	910-353-4853

Provider Business Practice Location Address
First Line	:	11 OFFICE PARK DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7326
Country	:	US
Telephone Number	:	910-353-9906
Fax Number	:	910-353-4853

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT ALLEN KRAUSE
Credential	:	MD
Telephone Number	:	910-353-9906

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	11/09/2009

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