Individual
RANDALL J CAMMENGA
Active
Individual
RANDALL J CAMMENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
01041177
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000082225
AANTHEM
IN
Enumeration date
07/29/2005
Last updated
03/20/2008
Update your record
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