Provider Demographics
NPI:1275700452
Name:MOLLY M. KRAMER M.D.,P.C.
Entity Type:Organization
Organization Name:MOLLY M. KRAMER M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:MCQUIGG
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-537-8099
Mailing Address - Street 1:PO BOX 1144
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30475-1144
Mailing Address - Country:US
Mailing Address - Phone:912-537-8099
Mailing Address - Fax:912-537-3828
Practice Address - Street 1:104 MAPLE DRIVE
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-1144
Practice Address - Country:US
Practice Address - Phone:912-537-8099
Practice Address - Fax:912-537-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047472207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000910005AMedicaid
GA000910005AMedicaid
GA16BBCCKMedicare PIN