Healthcare Provider Details

I. General information

NPI: 1477535169
Provider Name (Legal Business Name): JOSEPH G CRAMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E TWIN PEAKS ST
MIDVALE UT
84047-1215
US

IV. Provider business mailing address

5770 S 250 E SUITE 290
MURRAY UT
84107-8100
US

V. Phone/Fax

Practice location:
  • Phone: 801-568-6700
  • Fax:
Mailing address:
  • Phone: 801-747-8700
  • Fax: 801-747-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG89247
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number167151-1205
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: