Provider Demographics
NPI:1063498756
Name:KRAMER, ANDREW A (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:A
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 1:1600 MEDICAL WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2166
Mailing Address - Country:US
Mailing Address - Phone:770-972-7999
Mailing Address - Fax:770-972-9528
Practice Address - Street 1:1600 MEDICAL WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2166
Practice Address - Country:US
Practice Address - Phone:770-972-7999
Practice Address - Fax:770-972-9528
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58795208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL590-74693OtherBLUE CROSS BLUE SHIELD
FL266205100Medicaid
FL62875OtherBLUE CROSS BLUE SHIELD
GA650596740AMedicaid
FL62875AMedicare ID - Type Unspecified
GAP00396983Medicare PIN
AL590-74693OtherBLUE CROSS BLUE SHIELD
H18568Medicare UPIN