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General NPI Number Information
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NPI Number | 1730124298
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Entity Type | Individual
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Provider Name | MATTHEW C KAMMERER DPM
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 275 11TH ST S
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City | WAHPETON
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State | ND
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Zip | 58075-4655
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Country | US
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Telephone | 701-642-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 275 11TH ST S
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City | WAHPETON
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State | ND
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Zip | 58075-4655
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Country | US
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Telephone | 701-642-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 33
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 544
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License Number State | MN
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