Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 5901002229 | MI |
NPI | 1104039189 |
---|---|
Provider Name | Dr. Jeffrey Garret Cramblett |
First Address | Brownstown Twp, MI 48183-1021 |
Second Address | Brownstown Twp, MI 48183-1021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 25/02/2019 |