Healthcare Provider Details

I. General information

NPI: 1548242696
Provider Name (Legal Business Name): STEFFEN S CAMERON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 11/17/2009
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: 330-602-2821
Mailing address:
  • Phone: 330-602-7531
  • Fax: 330-602-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35066705
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: