Provider Demographics
NPI:1821376435
Name:CREMER, JAVIER (DO)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:CREMER
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 1:8901 W 74TH ST STE 145
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2271
Mailing Address - Country:US
Mailing Address - Phone:913-722-0020
Mailing Address - Fax:913-362-0583
Practice Address - Street 1:8901 W 74TH ST STE 145
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2271
Practice Address - Country:US
Practice Address - Phone:913-722-0020
Practice Address - Fax:913-362-0583
Is Sole Proprietor?:No
Enumeration Date:2011-07-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.140675207Y00000X
KS2015016359207YX0905X
MO2011016837207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881Medicare Oscar/Certification