Provider Demographics
NPI:1376565903
Name:OLIVEIRA, EDGAR KRAMER (MD)
Entity Type:Individual
Prefix:
First Name:EDGAR
Middle Name:KRAMER
Last Name:OLIVEIRA
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 1:420 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:ND
Mailing Address - Zip Code:58552
Mailing Address - Country:US
Mailing Address - Phone:701-254-5339
Mailing Address - Fax:701-254-5459
Practice Address - Street 1:511 ELM AVE
Practice Address - Street 2:LINTON MEDICAL CENTER
Practice Address - City:LINTON
Practice Address - State:ND
Practice Address - Zip Code:58552
Practice Address - Country:US
Practice Address - Phone:701-254-4531
Practice Address - Fax:701-254-5459
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND8874208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
G17774Medicare UPIN