Healthcare Provider Details

I. General information

NPI: 1043409444
Provider Name (Legal Business Name): STEFFEN CAMERON ET ALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 02/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 WABASH AVE NW
NEW PHILADELPHIA OH
44663-4143
US

IV. Provider business mailing address

551 WABASH AVE NW
NEW PHILADELPHIA OH
44663-4143
US

V. Phone/Fax

Practice location:
  • Phone: 330-602-7531
  • Fax:
Mailing address:
  • Phone: 330-602-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEFFEN SCOTT CAMERON
Title or Position: OWNER
Credential: MD
Phone: 330-602-7531