Provider Demographics
NPI:1457572620
Name:RYAN KRAMER MD PC
Entity Type:Organization
Organization Name:RYAN KRAMER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-985-8773
Mailing Address - Street 1:1370 S WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5439
Mailing Address - Country:US
Mailing Address - Phone:303-985-8773
Mailing Address - Fax:303-985-0827
Practice Address - Street 1:1370 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5439
Practice Address - Country:US
Practice Address - Phone:303-985-8773
Practice Address - Fax:303-985-0827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57059764Medicaid
D23894Medicare UPIN
CO57059764Medicaid