Provider Demographics
NPI:1619061363
Name:KAMER, KERRY (DO)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:KAMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 206
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-0206
Mailing Address - Country:US
Mailing Address - Phone:970-308-1307
Mailing Address - Fax:303-371-7364
Practice Address - Street 1:5855 STAPLETON DRIVE NORTH #A-130
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216
Practice Address - Country:US
Practice Address - Phone:303-371-7444
Practice Address - Fax:303-371-7364
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34558208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice