Individual
MARK S KERMGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-8492
(920) 926-8903
Mailing address
145 N MAIN ST, FOND DU LAC, WI 54935-3423
(920) 926-8492
(920) 926-8903
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34936020
WI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
36091592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023094885
BLUE SHIELD
WI
05
—
31984300
—
WI
05
—
36091592
—
IL
Enumeration date
12/22/2005
Last updated
08/16/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us