Provider Demographics
NPI:1730120965
Name:CRAMER, JILL (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:CRAMER
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 1:2955 MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6575
Mailing Address - Country:US
Mailing Address - Phone:540-381-6211
Mailing Address - Fax:540-645-6623
Practice Address - Street 1:2955 MARKET ST
Practice Address - Street 2:SUITE B
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-0001
Practice Address - Country:US
Practice Address - Phone:540-381-6211
Practice Address - Fax:540-645-6623
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237795174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH70202Medicare UPIN