Provider Demographics
NPI:1689646002
Name:KRAUT, NAOMI S (MD)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:S
Last Name:KRAUT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7253 AMBASSADOR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2710
Mailing Address - Country:US
Mailing Address - Phone:410-436-1151
Mailing Address - Fax:443-436-1256
Practice Address - Street 1:7253 AMBASSADOR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2710
Practice Address - Country:US
Practice Address - Phone:410-436-1151
Practice Address - Fax:443-436-1256
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00414262085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD770051200Medicaid
MDP01214451OtherRR MEDICARE
MDF00754Medicare UPIN
MD272579ZAGLMedicare PIN
MDF00754Medicare UPIN
MDJ062OtherB/C B/S
MD435L178CMedicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 02
DC2849OtherB/C B/S
MDKA80OtherB/C B/S