Provider Demographics
NPI:1124177639
Name:CRAMER, MICHAEL KELLY (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KELLY
Last Name:CRAMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12850 MIDDLEBROOK RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5255
Mailing Address - Country:US
Mailing Address - Phone:301-972-9191
Mailing Address - Fax:301-972-0207
Practice Address - Street 1:12850 MIDDLEBROOK RD
Practice Address - Street 2:SUITE 209
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5255
Practice Address - Country:US
Practice Address - Phone:301-972-9191
Practice Address - Fax:301-972-0207
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor