Provider Demographics
NPI:1841230950
Name:KAMMEYER, JOEL AARON (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:AARON
Last Name:KAMMEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE
Mailing Address - Street 2:FL 3
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-5334
Mailing Address - Fax:
Practice Address - Street 1:2222 CHERRY ST.
Practice Address - Street 2:SUITE 1400
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608
Practice Address - Country:US
Practice Address - Phone:419-251-4787
Practice Address - Fax:419-251-7817
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-087375207R00000X
NC2006-01021207R00000X
OH35087375207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0055374Medicaid
OH2622835Medicaid
OH2622835Medicaid