Provider Demographics
NPI:1225108905
Name:KRAMER, STEPHEN PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16154 MAIN AVE SE STE 134
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-4800
Mailing Address - Country:US
Mailing Address - Phone:952-447-3000
Mailing Address - Fax:
Practice Address - Street 1:16154 MAIN AVE SE STE 134
Practice Address - Street 2:
Practice Address - City:PRIOR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55372-4800
Practice Address - Country:US
Practice Address - Phone:952-447-3000
Practice Address - Fax:952-447-3561
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN44-00053OtherMEDICA PROVIDER #
MNHP31214OtherHEALTH PARTNERS ID#
MN230977OtherACN CHIRO CARE #
MN631728600Medicaid
MN87D95KROtherBCBS OF MN
MN44-00053OtherMEDICA PROVIDER #
MN230977OtherACN CHIRO CARE #