Provider Demographics
NPI:1295984060
Name:CRAMER, KATHI-JO (OD)
Entity type:Individual
Prefix:DR
First Name:KATHI-JO
Middle Name:
Last Name:CRAMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1920
Mailing Address - Country:US
Mailing Address - Phone:313-389-3937
Mailing Address - Fax:313-389-1113
Practice Address - Street 1:7333 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1920
Practice Address - Country:US
Practice Address - Phone:313-389-3937
Practice Address - Fax:313-389-1113
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H26854Medicare PIN
MIU31339Medicare UPIN