Provider Demographics
NPI:1407907439
Name:TEMAR, KERRY L (DPM)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:L
Last Name:TEMAR
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-1848
Mailing Address - Country:US
Mailing Address - Phone:513-791-5753
Mailing Address - Fax:513-791-2435
Practice Address - Street 1:5521 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-1848
Practice Address - Country:US
Practice Address - Phone:513-791-5753
Practice Address - Fax:513-791-2435
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003484213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2941080Medicaid
OH2941080Medicaid
OH4240362Medicare PIN