Provider Demographics
NPI:1912696659
Name:KEMKER, COLIN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:JOSEPH
Last Name:KEMKER
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 1:4333 EAST VALLEY COURT
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167
Mailing Address - Country:US
Mailing Address - Phone:812-620-7832
Mailing Address - Fax:
Practice Address - Street 1:221 NORTH CELIA AVENUE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303
Practice Address - Country:US
Practice Address - Phone:765-747-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program