Robert C Kamp II, PA-C

Individual provider Active NPI Physician Assistant · Munising, MI

NPI 1992739429 · NPPES record last updated Jan 24, 2013

Key facts

NPI
1992739429
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
1500 Sand Point Rd.
Munising, MI 49862-1406
Phone
(920) 387-4110
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1137WIMDPodiatrist
1137-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munising Memorial Hospital Association Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1137-023 WI
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

1500 Sand Point Rd.
Munising, MI 49862-1406

Mailing address

1500 Sand Point Rd.
Munising, MI 49862-1406
Phone (906) 387-4110

Other identifiers

IdentifierTypeStateIssuer
42989900MedicaidWI
23-8650OtherMIRHC CERTIFICATION NUMBER
970013386OtherWIMEDICARE RAILROAD
970013387OtherWIMEDICARE RAILROAD

Other providers in Munising, MI

All providers in Munising, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.