Provider Demographics
NPI:1295888436
Name:KRAMER, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
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 1:1050 OLD DES PERES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1873
Mailing Address - Country:US
Mailing Address - Phone:314-569-0612
Mailing Address - Fax:314-569-0618
Practice Address - Street 1:1050 OLD DES PERES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1873
Practice Address - Country:US
Practice Address - Phone:314-569-0612
Practice Address - Fax:314-569-0618
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1J53207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
43092556563080A001OtherWPS TRICARE
MOD76757OtherMERCY HEALTH PLANS
P00194627OtherRR MEDICARE
MO142248OtherHEALTHLINK
MO4134104OtherAETNA
MO21043OtherBCBS OF MO
MO3048031001OtherCIGNA
MO0900070OtherUNITED HEALTHCARE
MO1293OtherGROUP HEALTH PLAN
MO202779617Medicaid
MO202779617Medicaid
005010541Medicare PIN
43092556563080A001OtherWPS TRICARE