Provider Demographics
NPI:1134111552
Name:KEMP, ARNOLD MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:MICHAEL
Last Name:KEMP
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:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-7241
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:12750 ST FRANCIS DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-0264
Practice Address - Country:US
Practice Address - Phone:219-757-6121
Practice Address - Fax:219-681-6897
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95053207R00000X
IN01047261A207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000749287OtherANTHEM TRADITIONAL
616679523OtherDEPARTMENT OF LABOR
IN200148120Medicaid
P01017949OtherMEDICARE RR
IN000000749287OtherANTHEM TRADITIONAL
G44758Medicare UPIN