Healthcare Provider Details

I. General information

NPI: 1154351369
Provider Name (Legal Business Name): ROB JOSEPH KAMERMANS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N DR MARTIN LUTHER KING JR BLVD
CLOVIS NM
88101-9412
US

IV. Provider business mailing address

1612 N GUADALUPE ST
CARLSBAD NM
88220-8812
US

V. Phone/Fax

Practice location:
  • Phone: 505-769-7153
  • Fax: 505-769-7337
Mailing address:
  • Phone: 505-887-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number93-294
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: