Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E4722 | CA |
N | 222Z00000X | Podiatrist | E4722 | CA |
N | 213EP0504X | Public Medicine | E4722 | CA |
N | 213EP1101X | Primary Podiatric Medicine | E4722 | CA |
N | 111NR0200X | Radiology | E4722 | CA |
N | 213ER0200X | Radiology | E4722 | CA |
N | 2081S0010X | Sports Medicine | E4722 | CA |
N | 213ES0000X | Sports Medicine | E4722 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | E4722 | CA |
N | 213ES0131X | Foot Surgery | E4722 | CA |
NPI | 1497963078 |
---|---|
Provider Name | Dr. Kent Paul Cramer |
First Address | Westland, MI 48186-9728 |
Second Address | Fontana, CA 92335-6720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 06/12/2021 |