Individual
KENNETH P COLMER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
237 STATION AVE, SOUTH YARMOUTH, MA 02664
(508) 394-2116
(508) 760-1919
Mailing address
49 CARRIAGE LANE, YARMOUTH, MA 02675
(508) 362-1357
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60273
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3065855
—
MA
01
—
J09937
BLUE CROSS BLUE SHIELD
MA
Enumeration date
04/12/2006
Last updated
07/08/2007
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