Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 161162 | AK |
N | 2080P0205X | Pediatric Endocrinologist | ME95389 | FL |
NPI | 1487732640 |
---|---|
Provider Name | Dr. Mark A. Kummer |
First Address | Portland, OR 97208-4105 |
Second Address | Anchorage, AK 99508-4621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 12/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009936164 | (05) | AL |
05984726 | (05) | MS |
274908400 | (05) | FL |
A03443 | (02) | |
K171969 | (05) | AK |