Provider Demographics
NPI:1568588432
Name:KRAMER, KYLE VERNON (DO)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:VERNON
Last Name:KRAMER
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 1:1310 WISCONSIN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2472
Mailing Address - Country:US
Mailing Address - Phone:616-844-4528
Mailing Address - Fax:616-847-5608
Practice Address - Street 1:1310 WISCONSIN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2472
Practice Address - Country:US
Practice Address - Phone:616-846-2640
Practice Address - Fax:616-846-3110
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44009207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine