Provider Demographics
NPI:1598744740
Name:CRAM, LORIE F (MD)
Entity Type:Individual
Prefix:DR
First Name:LORIE
Middle Name:F
Last Name:CRAM
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 1:4225 ALTAMONT PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3063
Mailing Address - Country:US
Mailing Address - Phone:240-607-1500
Mailing Address - Fax:410-367-2215
Practice Address - Street 1:4225 ALTAMONT PL
Practice Address - Street 2:SUITE 201
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3063
Practice Address - Country:US
Practice Address - Phone:240-607-1500
Practice Address - Fax:410-367-2215
Is Sole Proprietor?:No
Enumeration Date:2006-01-15
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1994207Q00000X
MDD76898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142218003Medicaid
G81644Medicare UPIN
TX142218003Medicaid