MEDICARE: MARY ANN CAMERON MD

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
1	207RN0300X	Nephrology Physician	26208	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619924677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN CAMERON MD

Provider Business Mailing Address
First Line	:	6465 S YALE AVE
Second Line	:	SUITE 507
City	:	TULSA
State	:	OK
Zip	:	74136-7823
Country	:	US
Telephone Number	:	918-481-2760
Fax Number	:	918-481-2775

Provider Business Practice Location Address
First Line	:	6465 S YALE AVE
Second Line	:	SUITE 507
City	:	TULSA
State	:	OK
Zip	:	74136-7823
Country	:	US
Telephone Number	:	918-481-2760
Fax Number	:	918-481-2775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	02/14/2013

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Directions to “ MARY ANN CAMERON MD” Practice Location

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