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General NPI Number Information
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NPI Number | 1104997451
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Entity Type | Organization
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Legal Business Name | SERGIO MACHADO CAMARGO
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 110 LONG POND RD SUITE 205
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City | PLYMOUTH
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State | MA
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Zip | 02360-2642
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Country | US
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Telephone | 508-726-2284
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Fax | 508-747-5027
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Provider Business Mailing Address
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Address Line | PO BOX 1217
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City | PLYMOUTH
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State | MA
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Zip | 02362-1217
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Country | US
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Telephone | 508-726-2284
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Fax | 508-747-5027
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Authorized Official
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Title or Position | OWNER
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Name | SERGIO M CAMARGO
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Credential | M.D.
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Telephone | 508-746-2284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 75498
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License Number State | MA
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