Provider Demographics
NPI:1073537742
Name:CRAEMER, CHRIS W (MD)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:W
Last Name:CRAEMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR
Mailing Address - Street 2:STE 220 ADMINISTRATION
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:913-495-2000
Mailing Address - Fax:913-495-3715
Practice Address - Street 1:3515 BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2501
Practice Address - Country:US
Practice Address - Phone:847-797-0528
Practice Address - Fax:855-748-6239
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-23329207Q00000X
MOR4C99207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00790344OtherRR MEDICARE
E65679Medicare UPIN
KSP00790344OtherRR MEDICARE
KSK676288AMedicare PIN
MOK67000012Medicare PIN