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General NPI Number Information
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NPI Number | 1457808321
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Entity Type | Organization
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Legal Business Name | DORIN KEMMERLE MD LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 4350 COMMERCIAL ST SE
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City | SALEM
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State | OR
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Zip | 97302-3914
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Country | US
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Telephone | 503-877-4485
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 COMMERCIAL ST SE
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City | SALEM
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State | OR
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Zip | 97302-3914
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Country | US
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Telephone | 503-877-4485
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. DORIN KEMMERLE
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Credential | MD
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Telephone | 503-877-4485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD22473
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License Number State | OR
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