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General NPI Number Information
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NPI Number | 1184803116
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Entity Type | Individual
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Provider Name | RICHARD F. CAMINO GAZTAMBIDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 997 SAINT SEBASTIAN WAY
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City | AUGUSTA
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State | GA
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Zip | 30912-2613
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Country | US
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Telephone | 706-721-6597
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Fax | 706-721-6602
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Provider Business Mailing Address
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Address Line | 1499 WALTON WAY STE 1400 ATTN: D. RAIFORD
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City | AUGUSTA
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State | GA
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Zip | 30901-2603
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Country | US
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Telephone | 706-828-8401
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Fax | 706-722-7235
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 070352
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License Number State | GA
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