Cammenga, Randall J
Cammenga, Randall J is an individual health care provider with primary practice located at 600 East Blvd , Elkhart IN 46514-2483. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Cammenga, Randall J can be contacted via phone (574) 523-3161.Contact Information
Primary practice address
600 East Blvd
Elkhart IN 46514-2483
Phone: (574) 523-3161
Fax: (574) 523-3221
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 01041177 | Indiana |
Profile Details
| NPI number | 1154321107 |
|---|---|
| LBN Legal business name | Cammenga, Randall J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Mar 20th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154321107 | NPPES |
| Indiana | Other | 000000082225 | AANTHEM |
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