Provider Demographics
NPI:1285771931
Name:KRAMER, PETER GIBBS (DO)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:GIBBS
Last Name:KRAMER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1721 ALLENS LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3661
Practice Address - Country:US
Practice Address - Phone:910-344-8900
Practice Address - Fax:910-344-8902
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1285771931Medicaid
NC891292MMedicaid
NC891292MMedicaid
NC1285771931Medicaid
NC2401215BMedicare PIN
NC2401215CMedicare PIN
NCH46904Medicare UPIN