Provider Demographics
NPI:1437039856
Name:CRAMER, CORY BRETT
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:BRETT
Last Name:CRAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9093 E STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:47424-6054
Mailing Address - Country:US
Mailing Address - Phone:812-227-1941
Mailing Address - Fax:
Practice Address - Street 1:9093 E STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IN
Practice Address - Zip Code:47424-6054
Practice Address - Country:US
Practice Address - Phone:812-227-1941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant