Provider Demographics
NPI:1205976321
Name:KRAMER, MICHAEL ERIK (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ERIK
Last Name:KRAMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MACHIGONNE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2046
Mailing Address - Country:US
Mailing Address - Phone:207-871-7102
Mailing Address - Fax:
Practice Address - Street 1:17 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3914
Practice Address - Country:US
Practice Address - Phone:207-772-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS529103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical