Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 125.061127 | IL |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301114390 | MI |
NPI | 1093078834 |
---|---|
Provider Name | Dr. John David Cramer |
First Address | Troy, MI 48083-1135 |
Second Address | Chicago, IL 60611-2927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2012 |
Last Update Date | 15/12/2020 |