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General NPI Number Information
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NPI Number | 1093078834
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Entity Type | Individual
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Provider Name | JOHN DAVID CRAMER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 676 N SAINT CLAIR ST GALTER 15-200
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City | CHICAGO
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State | IL
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Zip | 60611-2927
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Country | US
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Telephone | 312-695-8182
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 E MAPLE RD
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City | TROY
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State | MI
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Zip | 48083-1135
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Country | US
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Telephone | 248-581-5729
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Fax | 248-581-5643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301114390
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 125.061127
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License Number State | IL
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