Healthcare Provider Details

I. General information

NPI: 1316280308
Provider Name (Legal Business Name): KATHRYN ELIZABETH KRAMER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN ELIZABETH IRWIN

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 11/03/2023
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 MONROE ST UNIT 203
SYLVANIA OH
43560-2735
US

IV. Provider business mailing address

5700 MONROE ST UNIT 203
SYLVANIA OH
43560-2735
US

V. Phone/Fax

Practice location:
  • Phone: 567-585-1983
  • Fax: 419-824-7359
Mailing address:
  • Phone: 419-841-8100
  • Fax: 419-841-4681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34011959
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: