Provider Demographics
NPI:1467432583
Name:GRAMAS, DEIRDRE A (MD)
Entity Type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:A
Last Name:GRAMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4243
Mailing Address - Country:US
Mailing Address - Phone:207-594-4308
Mailing Address - Fax:207-594-3326
Practice Address - Street 1:817 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4243
Practice Address - Country:US
Practice Address - Phone:207-594-4308
Practice Address - Fax:207-594-3326
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013712207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM5297Medicare PIN