Provider Demographics
NPI:1013574714
Name:KAMMER, JAMES GERARD
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GERARD
Last Name:KAMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LACEBARK ST
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-4343
Mailing Address - Country:US
Mailing Address - Phone:219-670-1033
Mailing Address - Fax:
Practice Address - Street 1:300 LACEBARK ST
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-4343
Practice Address - Country:US
Practice Address - Phone:219-670-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health