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NPI Code Detail

MEDICARE: JUAN CARLOS CAMACHO VELAZQUEZ M.D.

MEDICARE: JUAN CARLOS CAMACHO VELAZQUEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician85460SC

General Provider Information

NPI Number : 1063816528
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN CARLOS CAMACHO VELAZQUEZ M.D.
Provider Business Mailing Address
First Line : 100 CALLEN BLVD
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29486-2807
Country : US
Telephone Number : 843-529-3100
Fax Number :
Provider Business Practice Location Address
First Line : 100 CALLEN BLVD
Second Line :
City : SUMMERVILLE
State : SC
Zip : 29486-2807
Country : US
Telephone Number : 843-529-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2014
Last Update Date : 12/15/2023

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Directions to “ JUAN CARLOS CAMACHO VELAZQUEZ M.D.” Practice Location

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