MEDICARE: MARIE ALICIA KRAMER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D0057990	MD

General Provider Information

NPI Number	:	1275962573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE ALICIA KRAMER M.D.

Provider Business Mailing Address
First Line	:	17020 EVNA RD
Second Line	:
City	:	PARKTON
State	:	MD
Zip	:	21120-9772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 YORK RD STE 103
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-2256
Country	:	US
Telephone Number	:	443-841-7668
Fax Number	:	443-841-7644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	06/06/2017

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