Healthcare Provider Details

I. General information

NPI: 1801945464
Provider Name (Legal Business Name): RYAN KRAMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 SO WADSWORTH BLVD
LAKEWOOD CO
80232-5439
US

IV. Provider business mailing address

1370 SO WADSWORTH BLVD
LAKEWOOD CO
80232-5439
US

V. Phone/Fax

Practice location:
  • Phone: 303-985-8773
  • Fax: 303-985-0827
Mailing address:
  • Phone: 303-985-8773
  • Fax: 303-985-0827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCO21165
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: