Provider Demographics
NPI:1235136920
Name:KRAMER, RALPH LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:LEWIS
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:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:VA
Mailing Address - Zip Code:24171-1019
Mailing Address - Country:US
Mailing Address - Phone:276-694-4466
Mailing Address - Fax:276-694-2909
Practice Address - Street 1:18877 JEB STUART HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:VA
Practice Address - Zip Code:24171
Practice Address - Country:US
Practice Address - Phone:276-694-4466
Practice Address - Fax:276-694-2909
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039409207Q00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006211313Medicaid
VA282809OtherANTHEM BCBS
VA006211313Medicaid
VAC89301Medicare UPIN