Doctor Name: | MARK S KERMGARD |
NPI Number: | 1023094885 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 36091592 |
Business Practice Address: | 430 E Division St Fond Du Lac, WI - 549354560 |
Business Phone Number: | 9209292300 |
Business Fax Number: | |
Mailing Address: | 420 E Division St, FOND DU LAC |
State: | WI |
Postal Code: | 549354560 |
Phone Number: | 9209268340 |
Fax Number: | 9209268370 |
NPI Enumeration Date: | 12/22/2005 |
NPI Last Update Date: | 03/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207PE0004X |
License Number: | 36091592 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Emergency Medicine |
Taxonomy Specialization: | Emergency Medical Services |
Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |