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NPI Code Detail

MEDICARE: MARY S KRAEMER MD

MEDICARE: MARY S KRAEMER MD
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
1207R00000XInternal Medicine PhysicianMD423477PA
2207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianMD423477PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568450468
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY S KRAEMER MD
Provider Business Mailing Address
First Line : 2450 W HUNTING PARK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1302
Country : US
Telephone Number : 215-707-1800
Fax Number : 215-707-3644
Provider Business Practice Location Address
First Line : 3322 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5185
Country : US
Telephone Number : 215-707-1800
Fax Number : 215-707-3644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2005
Last Update Date : 12/10/2020

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Directions to “ MARY S KRAEMER MD” Practice Location

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