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General NPI Number Information
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NPI Number | 1023247194
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Entity Type | Individual
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Provider Name | CAMERON HATAM D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 50 S PICKETT ST #114
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7207
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Country | US
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Telephone | 703-370-5300
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Fax | 703-370-0080
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Provider Business Mailing Address
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Address Line | 344 MAPLE AVE W #231
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City | VIENNA
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State | VA
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Zip | 22180-5612
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Country | US
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Telephone | 703-370-5300
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Fax | 703-370-0080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556722
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License Number State | VA
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