1033155395 NPI number — DANIEL WILLIAM CRAMER MD SCD

Table of content: DANIEL WILLIAM CRAMER MD SCD (NPI 1033155395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033155395 NPI number — DANIEL WILLIAM CRAMER MD SCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRAMER
Provider First Name:
DANIEL
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD SCD
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1033155395
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 LONGWOOD AVE
Provider Second Line Business Mailing Address:
BRIGHAM AND WOMENS HOSP DEPT OF OBSTETRICS AND GYNECOLO
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-732-4895
Provider Business Mailing Address Fax Number:
617-732-4899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 LONGWOOD AVE
Provider Second Line Business Practice Location Address:
BRIGHAM AND WOMENS HOSP DEPT OF OBSTETRICS AND GYNECOLO
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-732-4895
Provider Business Practice Location Address Fax Number:
617-732-4899
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  37133 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2052377 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 65526 . This is a "FALLON COMMUNITY HEALT PL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2636187 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 731183 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: M09368 . This is a "BCBS INDEMNITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132150 . This is a "HPHC BINNEY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132149 . This is a "HPHC DFCI" identifier . This identifiers is of the category "OTHER".




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