Physician Compare National (NPI:1689997934)

HEALTHCARE PROVIDER: BONNIE PETRIE CRAEMER L.C.S.W

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1689997934
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618246299
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170713002107
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CRAEMER
	Individual professional last name
Provider First Name	BONNIE
	Individual professional first name
Provider Middle Name	PETRIE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	8910 MAIN ST
	Group Practice or individual's line 1 address
City	WOODSTOCK
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	301884916
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7709241818304
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y