Healthcare Provider Details

I. General information

NPI: 1689106460
Provider Name (Legal Business Name): BRENT KRAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 W 57TH ST
SIOUX FALLS SD
57108-3162
US

IV. Provider business mailing address

3101 W 57TH ST
SIOUX FALLS SD
57108-3162
US

V. Phone/Fax

Practice location:
  • Phone: 607-361-3937
  • Fax: 605-371-7199
Mailing address:
  • Phone: 605-361-3937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2021-01093
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: