Provider Demographics
NPI:1508863457
Name:KRAM, BARRY WILLIAM (DO)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:WILLIAM
Last Name:KRAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4605
Mailing Address - Country:US
Mailing Address - Phone:231-739-6375
Mailing Address - Fax:231-830-8122
Practice Address - Street 1:1277 MERCY DR
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-4605
Practice Address - Country:US
Practice Address - Phone:231-739-6375
Practice Address - Fax:231-830-8122
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009485207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE31577Medicare UPIN