Healthcare Provider Details

I. General information

NPI: 1932527553
Provider Name (Legal Business Name): DAVID KRAMER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 S RAINBOW BLVD STE 260
LAS VEGAS NV
89118-1896
US

IV. Provider business mailing address

3016 W CHARLESTON BLVD STE 100
LAS VEGAS NV
89102-1973
US

V. Phone/Fax

Practice location:
  • Phone: 702-992-6888
  • Fax:
Mailing address:
  • Phone: 702-405-6503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS14146
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: