Provider Demographics
NPI:1215914916
Name:KRAMER, MICHAEL SIMON (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SIMON
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4099 MCEWEN RD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5030
Mailing Address - Country:US
Mailing Address - Phone:972-484-4844
Mailing Address - Fax:972-484-0711
Practice Address - Street 1:4099 MCEWEN RD
Practice Address - Street 2:SUITE 132
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5030
Practice Address - Country:US
Practice Address - Phone:972-484-4844
Practice Address - Fax:972-484-0711
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2013-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF3526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF3526OtherTEXAS STATE LICENSE
TXC18034Medicare UPIN