Provider Demographics
NPI:1861450835
Name:KRAFT, PAUL CHRISTIAN (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CHRISTIAN
Last Name:KRAFT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6774 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-2873
Mailing Address - Country:US
Mailing Address - Phone:248-620-6568
Mailing Address - Fax:
Practice Address - Street 1:165 W AUBURN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5002
Practice Address - Country:US
Practice Address - Phone:248-299-2620
Practice Address - Fax:248-299-2627
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPK005745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5260086OtherAETNA
MI123532OtherPREFERRED CHOICES
MI4943355Medicaid
MI95-OF31744-0OtherBCBS
MICH630035OtherM-CARE
MI95-OF31744-0OtherBCBS
MIU59113Medicare UPIN