Provider Demographics
NPI:1053351783
Name:KRAMER, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT, PHYS. DIV.
Mailing Address - Street 2:2ND FL, CBO2-3, ATTN: CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-792-7445
Mailing Address - Fax:513-791-4042
Practice Address - Street 1:9250 BLUE ASH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-6822
Practice Address - Country:US
Practice Address - Phone:513-792-7445
Practice Address - Fax:513-792-7451
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.038516207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH272352575066OtherCARESOURCE
OH0489234OtherOH MEDICAID
OH710738OtherBUCKEYE - MEDICARE
OH777640OtherBUCKEYE - MEDICAID
OH4026318OtherAETNA
OH796245OtherANTHEM
OHH151780OtherOH MEDICARE
OH272352575OtherMULTIPLAN
OH724137OtherWELLCARE
OHP01180681OtherRR MEDICARE