Provider Demographics
NPI:1023076338
Name:KREMER, GERALD L (MD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:L
Last Name:KREMER
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:L-3549
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-0001
Mailing Address - Country:US
Mailing Address - Phone:740-383-7090
Mailing Address - Fax:740-383-7942
Practice Address - Street 1:6 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1047
Practice Address - Country:US
Practice Address - Phone:740-363-9021
Practice Address - Fax:740-383-7942
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057043K207Q00000X
OH35.057043207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000118408OtherANTHEM
0100783OtherUHC
634547OtherAETNA
311098079019OtherCIGNA
OH0774783Medicaid
080033028OtherTRAVELERS MEDICARE
311098079OtherPPO NEXT
634547OtherAETNA
E70300Medicare UPIN
OHH132060Medicare PIN