Provider Demographics
NPI:1528016888
Name:CRAMER, DAVID T (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:CRAMER
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 1:1301 GREENMONT CIR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-3295
Mailing Address - Country:US
Mailing Address - Phone:304-580-0105
Mailing Address - Fax:
Practice Address - Street 1:1907 ANN ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-2504
Practice Address - Country:US
Practice Address - Phone:304-424-4205
Practice Address - Fax:304-424-4283
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19675207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
001722066OtherBLUE CROSS/BLUE SHIELD
WV1807509000Medicaid
080156968OtherRAILROAD MEDICARE
OH2187235Medicaid
001722066OtherBLUE CROSS/BLUE SHIELD
WV1807509000Medicaid