Provider Demographics
NPI:1336433432
Name:KAEHR, ELLEN WAYMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:WAYMAN
Last Name:KAEHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ROSEHILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1762
Mailing Address - Country:US
Mailing Address - Phone:517-212-2008
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 144
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3053
Practice Address - Country:US
Practice Address - Phone:317-762-8194
Practice Address - Fax:317-762-8196
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072625A207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine