Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 35 . 032567 | OH |
NPI | 1083685952 |
---|---|
Provider Name | Dr. Gary M. Kammer |
First Address | Concord Twp, OH 44077-9176 |
Second Address | Willoughby, OH 44094-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 26/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0399251 | (05) | OH |
A79029 | (02) | OH |
H480820 | MEDICARE (01) | OH |