Marek J Kaminski, MD, PHD

Individual provider Active NPI Dermatology Physician · Liberal, KS

NPI 1720183742 · NPPES record last updated Apr 14, 2020

Key facts

NPI: 1720183742
Entity type: Individual (NPI type 1)
Primary specialty: Dermatology Physician 207N00000X
License: 0427386 (KS)
Practice address: 15 E 11TH St
Liberal, KS 67901-2720
Phone: (620) 624-9100
Fax: (620) 624-9107
NPI assigned: Sep 14, 2006
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine, Doctor of Philosophy

State licenses

License	State	Type	Specialty
J0974	TX	MD	Dermatology Physician

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dermatology Physician	207N00000X	J0974	TX
Dermatology Physician	207N00000X	0427386	KS	Yes

Addresses

Primary practice location

15 E 11TH St
Liberal, KS 67901-2720

Mailing address

PO Box 1215
Liberal, KS 67905-1215
Phone (620) 629-6638

Other identifiers

Identifier	Type	State	Issuer
070015368	Other	KS	RAILROAD MEDICARE
100309860C	Medicaid	KS
060689	Other	KS	BLUE CROSS BLUE SHIELD

Other providers in Liberal, KS

Julio Jimenez, D.C
John a Buie, M.D. P.C.
Rosemary Renata Juarez, PHARM D
Jury, Farrar and Associates, Doctors of Optometry, PA
K&T LLC
James J Karlan, LCP, LMLP
Firas I. Kawtharani, M.D.
Laci Kinser
Angela Kirk, APRN
Dennis Knudsen, M.D.

All providers in Liberal, KS · Dermatology Physician in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.