Provider Demographics
NPI:1093707432
Name:KRAEMER, THOMAS G (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:KRAEMER
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 1:2900 LAMB CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6480
Mailing Address - Country:US
Mailing Address - Phone:540-731-4578
Mailing Address - Fax:540-731-0867
Practice Address - Street 1:2900 LAMB CIR STE 202
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6480
Practice Address - Country:US
Practice Address - Phone:540-731-4578
Practice Address - Fax:540-731-0867
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701017207V00000X
VA0101265277207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891064YMedicaid
NC1064YOtherBCBS NC
NCG28179Medicare UPIN
NC1064YOtherBCBS NC