Provider Demographics
NPI:1134166093
Name:KAMSLER, MARK
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:KAMSLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 RICHARDS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-8321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1005 RICHARDS RD
Practice Address - Street 2:SUITE A
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8321
Practice Address - Country:US
Practice Address - Phone:262-912-0263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36425020208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics