Provider Demographics
NPI:1851439103
Name:KAMM, RONALD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:KAMM
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 1:257 MONMOUTH RD
Mailing Address - Street 2:A-5
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1500
Mailing Address - Country:US
Mailing Address - Phone:732-517-0595
Mailing Address - Fax:732-517-8585
Practice Address - Street 1:257 MONMOUTH RD
Practice Address - Street 2:A-5
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1500
Practice Address - Country:US
Practice Address - Phone:732-517-0595
Practice Address - Fax:732-517-8585
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02601500106H00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKA456693Medicare ID - Type Unspecified
NJC55833Medicare UPIN