Provider Demographics
NPI:1902894678
Name:CRAMER, SUSAN L (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HEALTHY WAY STE 1260
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7918
Mailing Address - Country:US
Mailing Address - Phone:864-225-3551
Mailing Address - Fax:864-328-0328
Practice Address - Street 1:100 HEALTHY WAY STE 1260
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-7918
Practice Address - Country:US
Practice Address - Phone:864-225-3551
Practice Address - Fax:864-328-0328
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18399174400000X
GA044892174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5557547OtherAETNA
SC8084Medicare ID - Type Unspecified
SC5557547OtherAETNA
G37955Medicare UPIN