Healthcare Provider Details

I. General information

NPI: 1437455185
Provider Name (Legal Business Name): ERIC M KRAMER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 8TH ST NE
MASSILLON OH
44646-8503
US

IV. Provider business mailing address

PO BOX 74994
CLEVELAND OH
44194-1077
US

V. Phone/Fax

Practice location:
  • Phone: 330-834-4788
  • Fax: 330-834-4789
Mailing address:
  • Phone: 614-430-5727
  • Fax: 614-430-5744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN317568
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: