Provider Demographics
NPI:1902967185
Name:CRAMER, MATTHEW T (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:T
Last Name:CRAMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 E. MARCONI AVE.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3133
Mailing Address - Country:US
Mailing Address - Phone:602-628-3993
Mailing Address - Fax:480-998-3944
Practice Address - Street 1:10505 N. 69TH ST.
Practice Address - Street 2:SUITE 1400
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253-4535
Practice Address - Country:US
Practice Address - Phone:480-998-3944
Practice Address - Fax:480-998-3944
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7408111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU49962Medicare UPIN
AZZ82980Medicare ID - Type Unspecified