Provider Demographics
NPI:1023128006
Name:KILMER-ERNST, PAULA K (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:K
Last Name:KILMER-ERNST
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M124
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-7500
Mailing Address - Fax:269-341-7540
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:BOX 42
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-8855
Practice Address - Fax:269-341-8743
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301070139208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1023128006Medicaid
MI1417961137OtherBCBSM
MIC97618193Medicare PIN
MI1023128006Medicaid