Provider Demographics
NPI:1376677799
Name:KRAMER, STUART L (DPM)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:L
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7007 BACKLICK CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-3937
Mailing Address - Country:US
Mailing Address - Phone:703-642-5340
Mailing Address - Fax:703-914-1549
Practice Address - Street 1:7007 BACKLICK CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3937
Practice Address - Country:US
Practice Address - Phone:703-642-5340
Practice Address - Fax:703-914-1549
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01030000403213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT30955Medicare UPIN
158027541Medicare ID - Type Unspecified