Individual
DR. CAMILLE M KURETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 E DOUGLAS RD, MISHAWAKA, IN 46545-1464
(574) 335-6242
(574) 335-6243
Mailing address
707 E CEDAR ST, STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01071180B
IN
208000000X
Pediatrics Physician
4301036427
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000200925
BCBS - COMM PEDS
IN
05
—
201067770
—
IN
05
—
4827848/10
—
MI
Enumeration date
03/14/2006
Last updated
09/14/2016
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