MEDICARE: CHRIS W CRAEMER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	04-23329	KS
2	207Q00000X	Family Medicine Physician	R4C99	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00790344	OTHER	KS	RR MEDICARE

General Provider Information

NPI Number	:	1073537742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS W CRAEMER M.D.

Provider Business Mailing Address
First Line	:	8550 MARSHALL DR
Second Line	:	STE 220 ADMINISTRATION
City	:	LENEXA
State	:	KS
Zip	:	66214-1505
Country	:	US
Telephone Number	:	913-495-2000
Fax Number	:	913-495-3715

Provider Business Practice Location Address
First Line	:	3515 BROADWAY BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2501
Country	:	US
Telephone Number	:	847-797-0528
Fax Number	:	855-748-6239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	01/31/2018

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Directions to “ CHRIS W CRAEMER M.D.” Practice Location

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