Provider Demographics
NPI:1467428938
Name:CREMER, STEVEN MARC (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MARC
Last Name:CREMER
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:P.O. BOX 14340
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29587
Mailing Address - Country:US
Mailing Address - Phone:843-236-9925
Mailing Address - Fax:843-236-6191
Practice Address - Street 1:4022 POSTAL WAY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579
Practice Address - Country:US
Practice Address - Phone:843-236-9925
Practice Address - Fax:843-236-6191
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC107547Medicaid
SC107547Medicaid
SCB919228689Medicare ID - Type Unspecified
SCB91922Medicare UPIN