Provider Demographics
NPI:1194320697
Name:CRAMER, MICHAEL
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CRAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 OLD MERCER RD
Mailing Address - Street 2:
Mailing Address - City:VOLANT
Mailing Address - State:PA
Mailing Address - Zip Code:16156-1421
Mailing Address - Country:US
Mailing Address - Phone:724-992-9706
Mailing Address - Fax:
Practice Address - Street 1:3933 PARKMAN RD NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-9142
Practice Address - Country:US
Practice Address - Phone:330-898-4129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445408183500000X
OH03230196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist