MEDICARE: AJITKUMAR KEMKAR MD

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
1	207R00000X	Internal Medicine Physician	MD27349	TN

General Provider Information

NPI Number	:	1679505168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJITKUMAR KEMKAR MD

Provider Business Mailing Address
First Line	:	2625 EXECUTIVE PARK NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-2721
Country	:	US
Telephone Number	:	423-472-9341
Fax Number	:	423-472-3746

Provider Business Practice Location Address
First Line	:	2625 EXECUTIVE PARK NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-2721
Country	:	US
Telephone Number	:	423-472-9341
Fax Number	:	423-472-3746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/08/2007

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