Provider Demographics
NPI:1154496917
Name:KEMERER, CHERYL L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:L
Last Name:KEMERER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6847 N CHESTNUT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3929
Mailing Address - Country:US
Mailing Address - Phone:330-297-8824
Mailing Address - Fax:330-296-2005
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-297-8824
Practice Address - Fax:330-296-2005
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076357208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2185933Medicaid
OHKE727623Medicare ID - Type Unspecified
OH2185933Medicaid