Provider Demographics
NPI:1912910555
Name:DAVID L KAMELHAR MD PLLC
Entity type:Organization
Organization Name:DAVID L KAMELHAR MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMELHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-685-6611
Mailing Address - Street 1:404 PARK AVE S
Mailing Address - Street 2:STE 701
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8412
Mailing Address - Country:US
Mailing Address - Phone:212-685-6611
Mailing Address - Fax:212-685-6626
Practice Address - Street 1:404 PARK AVE S
Practice Address - Street 2:SUITE 701
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8412
Practice Address - Country:US
Practice Address - Phone:212-685-6611
Practice Address - Fax:212-685-6626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00528872Medicaid
DK07V84910OtherBLUE SHIELD
DK07V84910OtherBLUE SHIELD