Healthcare Provider Details

I. General information

NPI: 1730418963
Provider Name (Legal Business Name): RAFAEL DANIEL CAMERINI-OTERO M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2009
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 5, ROOM 201 NIH
BETHESDA MD
20892-0538
US

IV. Provider business mailing address

BUILDING 5, ROOM 201 NIH
BETHESDA MD
20892-0538
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-2710
  • Fax: 301-594-1197
Mailing address:
  • Phone: 301-496-2710
  • Fax: 301-594-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberD0020801
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: