Healthcare Provider Details

I. General information

NPI: 1942061601
Provider Name (Legal Business Name): NATHANIEL S CAMARET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAVID GRANT MEDICAL CENTER, FAMILY MEDICINE
FAIRFIELD CA
94533
US

IV. Provider business mailing address

61 COW TRL
LIVINGSTON MT
59047-8828
US

V. Phone/Fax

Practice location:
  • Phone: 707-423-3000
  • Fax:
Mailing address:
  • Phone: 406-439-1674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: