Healthcare Provider Details

I. General information

NPI: 1497650576
Provider Name (Legal Business Name): BEACON FERTILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 OLD DOBBIN LN STE 100
COLUMBIA MD
21045-5817
US

IV. Provider business mailing address

6210 OLD DOBBIN LN STE 100
COLUMBIA MD
21045-5817
US

V. Phone/Fax

Practice location:
  • Phone: 484-888-3792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. KATHERINE CAMERON
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 484-888-3792