Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 18393 | MA |
NPI | 1053481077 |
---|---|
Provider Name | Dr. Michael Anastasios Kramer |
First Address | Sudbury, MA 01776-3376 |
Second Address | Sudbury, MA 01776-3376 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 06/03/2013 |