Provider Demographics
NPI:1902885056
Name:CRAMER, ANNE R (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:R
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 EASTERN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2788
Mailing Address - Country:US
Mailing Address - Phone:563-323-0026
Mailing Address - Fax:563-326-4280
Practice Address - Street 1:5335 EASTERN AVE STE C
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2788
Practice Address - Country:US
Practice Address - Phone:563-323-0026
Practice Address - Fax:563-326-4280
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108374208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI15057Medicare PIN
D80398Medicare UPIN
P00228659Medicare PIN
ILK19728Medicare PIN