Healthcare Provider Details

I. General information

NPI: 1801987383
Provider Name (Legal Business Name): WAYNE B KRAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15005 SHADY GROVE RD SUITE 120
ROCKVILLE MD
20850-6340
US

IV. Provider business mailing address

15005 SHADY GROVE RD SUITE 120
ROCKVILLE MD
20850-6340
US

V. Phone/Fax

Practice location:
  • Phone: 301-251-8611
  • Fax: 301-251-8779
Mailing address:
  • Phone: 301-251-8611
  • Fax: 301-251-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberD0050638
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: