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NPI Code Detail

MEDICARE: DR. JACQUELINE MOREAU KEMP MD, MS

MEDICARE: DR. JACQUELINE MOREAU KEMP MD, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician279357MA

General Provider Information

NPI Number : 1598183709
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE MOREAU KEMP MD, MS
Provider Business Mailing Address
First Line : 900 CUMMINGS CTR STE 311T
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6260
Country : US
Telephone Number : 978-225-3376
Fax Number : 978-560-1245
Provider Business Practice Location Address
First Line : 900 CUMMINGS CTR STE 311T
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6260
Country : US
Telephone Number : 978-225-3376
Fax Number : 978-560-1245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2014
Last Update Date : 10/11/2022

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