Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 20150228811 | MO |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 20150228811 | MO |
NPI | 1235512286 |
---|---|
Provider Name | Dr. Carl Edward Kramer |
First Address | Saint Louis, MO 63121-4617 |
Second Address | Saint Louis, MO 63121-4617 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2015 |
Last Update Date | 29/04/2020 |