Provider Demographics
NPI:1508122417
Name:KRAMER, MARK STEVEN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 LANTERN CIR
Mailing Address - Street 2:OFFICE #200
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1029
Mailing Address - Country:US
Mailing Address - Phone:215-498-1820
Mailing Address - Fax:
Practice Address - Street 1:1412 LANTERN CIR
Practice Address - Street 2:OFFICE #200
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1029
Practice Address - Country:US
Practice Address - Phone:215-498-1820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019924E207R00000X, 2084B0040X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry