MEDICARE: DR. CARRIE J KREMER 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	207V00000X	Obstetrics & Gynecology Physician	46471	MN

General Provider Information

NPI Number	:	1205811387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARRIE J KREMER M.D.

Provider Business Mailing Address
First Line	:	8170 33RD AVE S
Second Line	:	MS 21110Q
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-4516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 NICOLLET AVE S
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55420-2824
Country	:	US
Telephone Number	:	952-541-2800
Fax Number	:	952-886-7015

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	03/17/2022

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