Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 036721 | FL |
Y | 207RR0500X | Rheumatology | 058054 | GA |
NPI | 1144216656 |
---|---|
Provider Name | Dr. Alan Harvey Kramer |
First Address | Suwanee, GA 30024-9119 |
Second Address | Suwanee, GA 30024-9119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 15/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
50975 | MEDICARE PTAN (01) | |
D62734 | (02) | FL |