Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2007-01941 | NC |
N | 207Q00000X | Family Doctor | 32278 | SC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 53023 | CO |
NPI | 1366406027 |
---|---|
Provider Name | Andrew W. Kamell |
First Address | Pueblo, CO 81003-2710 |
Second Address | Pueblo, CO 81003-2710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 14/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
29289246 | (05) | CO |