Healthcare Provider Details

I. General information

NPI: 1518585207
Provider Name (Legal Business Name): CAMERON A CHOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 IRVING AVE STE 504
SYRACUSE NY
13210
US

IV. Provider business mailing address

725 IRVING AVE STE 504
SYRACUSE NY
13210
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-8444
  • Fax: 315-464-8445
Mailing address:
  • Phone: 315-464-8444
  • Fax: 315-464-8445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number325809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: