Provider Demographics
NPI:1679686216
Name:KEMELHAR, KEVIN JON (MED EDS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JON
Last Name:KEMELHAR
Suffix:
Gender:M
Credentials:MED EDS
Other - Prefix:
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Mailing Address - Street 1:23612 E SILSBY RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-381-4960
Mailing Address - Fax:
Practice Address - Street 1:23250 CHAPRIN BLVD
Practice Address - Street 2:#425 DR ELLEN F CASPER PHD & ASSOCIATES
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-464-4243
Practice Address - Fax:216-595-8210
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool