Provider Demographics
NPI:1689838443
Name:CRAM, RICHARD KEITH (AUD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KEITH
Last Name:CRAM
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 MONTGOMERY BLVD NE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2501
Mailing Address - Country:US
Mailing Address - Phone:505-247-4224
Mailing Address - Fax:505-247-1772
Practice Address - Street 1:9500 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 215
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2501
Practice Address - Country:US
Practice Address - Phone:505-247-4224
Practice Address - Fax:505-247-1772
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4362231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist