Provider Demographics
NPI:1447266150
Name:KAMER, GARY LOUIS (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:LOUIS
Last Name:KAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W LOOMIS RD
Mailing Address - Street 2:218
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8887
Mailing Address - Country:US
Mailing Address - Phone:414-929-9100
Mailing Address - Fax:414-929-9100
Practice Address - Street 1:9200 W LOOMIS RD
Practice Address - Street 2:218
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8887
Practice Address - Country:US
Practice Address - Phone:414-929-9100
Practice Address - Fax:414-929-9100
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI25313020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000001980Medicare ID - Type Unspecified
WIB53977Medicare UPIN