Individual
JOSEPH A KACMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 N COURT ST, CROWN POINT, IN 46307-3931
(219) 663-0815
(219) 663-7310
Mailing address
123 N COURT ST, CROWN POINT, IN 46307-3931
(219) 663-0815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027088A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000255544
BLUE SHIELD
IN
05
—
100158480A
—
IN
Enumeration date
12/27/2005
Last updated
11/20/2012
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