Healthcare Provider Details

I. General information

NPI: 1750801312
Provider Name (Legal Business Name): DR. KHALIL KAMAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date: 02/01/2018
Reactivation Date: 03/01/2018

III. Provider practice location address

33 WHITING HILL RD STE 21
BREWER ME
04412-1022
US

IV. Provider business mailing address

489 STATE ST
BANGOR ME
04401-6616
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7478
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD26393
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: