Kraetsch, Robert Elroy

Kraetsch, Robert Elroy is an individual health care provider with primary practice located at 400 Medical Plz Suite 100, Lake St Louis MO 63367-1490. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Kraetsch, Robert Elroy can be contacted via phone (636) 639-8600.

Contact Information

Primary practice address
400 Medical Plz Suite 100 Lake St Louis MO 63367-1490
Phone: (636) 639-8600
Fax: (636) 639-8666
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X R6140 Missouri

Profile Details

NPI number 1609839281
LBN Legal business name Kraetsch, Robert Elroy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Aug 27th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609839281 NPPES
Missouri MEDICAID 202536827
Missouri Other 3603013
Missouri Other 110189320
Missouri Other 58811
Missouri Other 121347
Missouri Other 134622
Missouri Other 4000561

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