1801987383 NPI number — WAYNE B KRAMER M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801987383 NPI number — WAYNE B KRAMER M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KRAMER

Provider First Name:

WAYNE

Provider Middle Name:

B

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1801987383

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/03/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

15005 SHADY GROVE RD

Provider Second Line Business Mailing Address:

SUITE 120

Provider Business Mailing Address City Name:

ROCKVILLE

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

20850-6340

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

301-251-8611

Provider Business Mailing Address Fax Number:

301-251-8779

Provider First Line Business Practice Location Address:

15005 SHADY GROVE RD

Provider Second Line Business Practice Location Address:

SUITE 120

Provider Business Practice Location Address City Name:

ROCKVILLE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

20850-6340

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

301-251-8611

Provider Business Practice Location Address Fax Number:

301-251-8779

Provider Enumeration Date:

09/27/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207VM0101X , with the licence number:  D0050638 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 517750261 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 496620 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 0706806 . This is a "AMERICHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 1490226 . This is a "FIRST HEALTH/COVENTRY" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 221489 . This is a "KAISER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 011548 . This is a "PRIOPRITY PARTNER (JOHN HOPKINS HEALTH PLAN)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 0001 . This is a "BCBS NCA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
• Identifier: 1385365 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 501487 . This is a "NCPPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 543735 . This is a "BCBS MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 7485755 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".