Healthcare Provider Details

I. General information

NPI: 1295942308
Provider Name (Legal Business Name): LILY ALEMI CAMERON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7864 RICHMOND TAPPAHANNOCK HWY
AYLETT VA
23009-3056
US

IV. Provider business mailing address

13100 NOISETTES CIR
ASHLAND VA
23005-7469
US

V. Phone/Fax

Practice location:
  • Phone: 804-535-0145
  • Fax:
Mailing address:
  • Phone: 804-305-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101257940
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: