Healthcare Provider Details

I. General information

NPI: 1053504399
Provider Name (Legal Business Name): BENJAMIN CHARLES KRAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S SHARON AMITY RD STE 100
CHARLOTTE NC
28211-3870
US

IV. Provider business mailing address

PO BOX 60160
CHARLOTTE NC
28260-0160
US

V. Phone/Fax

Practice location:
  • Phone: 704-365-0555
  • Fax: 704-367-8120
Mailing address:
  • Phone: 704-365-0555
  • Fax: 704-367-8122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2012-00154
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number33790
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number2012-00154
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number33790
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: