Provider Demographics
NPI:1760412613
Name:KRAMER, MICHAEL AARON (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:AARON
Last Name:KRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 BARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608-2409
Mailing Address - Country:US
Mailing Address - Phone:203-333-3030
Mailing Address - Fax:
Practice Address - Street 1:471 BARNUM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-2409
Practice Address - Country:US
Practice Address - Phone:203-333-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT81285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10608640OtherCAQH PROVIDER ID
ILBK4947175OtherDEA NUMBER
IL336054608OtherCONTROLLED SUBSTANCE
ILBK4947175OtherDEA NUMBER
IL04930316OtherBCBS PROVIDER NUMBER
ILG29003Medicare UPIN
ILBK4947175OtherDEA NUMBER
IL036093311OtherSTATE LICENSE
IL364456682OtherSTATE TAX ID NUMBER