Provider Demographics
NPI:1881726982
Name:KREMER, CAROLE CRISTINE (D O)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:CRISTINE
Last Name:KREMER
Suffix:
Gender:F
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8209 MCCANDLISH RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7422
Mailing Address - Country:US
Mailing Address - Phone:810-636-2901
Mailing Address - Fax:810-636-4216
Practice Address - Street 1:8209 MCCANDLISH RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7422
Practice Address - Country:US
Practice Address - Phone:810-636-2901
Practice Address - Fax:810-636-4216
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010070982084P0804X, 207Q00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS003791LOtherSTATE LICENSE
CA20A4192OtherSTATE LICENSE