Provider Demographics
NPI:1720213259
Name:KAMERSCHEN, ANTHONY V (MD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:V
Last Name:KAMERSCHEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3409 LUDINGTON STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829
Mailing Address - Country:US
Mailing Address - Phone:906-786-8343
Mailing Address - Fax:906-789-4430
Practice Address - Street 1:3409 LUDINGTON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-4212
Practice Address - Country:US
Practice Address - Phone:906-786-8343
Practice Address - Fax:906-789-4430
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2021-11-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301094554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1720213259Medicaid