Provider Demographics
NPI:1316099054
Name:KRAMER, GARY S (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:S
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:239 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1640
Mailing Address - Country:US
Mailing Address - Phone:814-539-5987
Mailing Address - Fax:814-535-4176
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-539-5987
Practice Address - Fax:814-535-4176
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD057428L2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001697006Medicaid
PA011612Medicare ID - Type UnspecifiedPA MEDICARE
G74231Medicare UPIN