Healthcare Provider Details

I. General information

NPI: 1598604860
Provider Name (Legal Business Name): CAMERON CHRISTIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11530 ALLISONVILLE RD STE 100
FISHERS IN
46038-1862
US

IV. Provider business mailing address

4548 W BETHEL AVE APT 123
MUNCIE IN
47304-5583
US

V. Phone/Fax

Practice location:
  • Phone: 317-742-9730
  • Fax:
Mailing address:
  • Phone: 317-742-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: