Kermgard, Mark S

Kermgard, Mark S is an individual health care provider with primary practice located at 145 N Main St , Fond Du Lac WI 54935-3423. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Kermgard, Mark S can be contacted via phone (920) 926-8492.

Contact Information

Primary practice address
145 N Main St Fond Du Lac WI 54935-3423
Phone: (920) 926-8492
Fax: (920) 926-8903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 36091592 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 34936020 Wisconsin

Profile Details

NPI number 1023094885
LBN Legal business name Kermgard, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Aug 16th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023094885 NPPES
Illinois MEDICAID 36091592
Illinois MEDICAID 31984300
Illinois Other 1023094885

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