NPI Code Details Logo

NPI 1205769312

NPI 1205769312 : CAMERON DUVALL : NORTH CHARLESTON, SC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1205769312
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CAMERON DUVALL
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/08/2026
-----------------------------------------------------
    Last Update Date     |    06/08/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2890 TRICOM ST 
-----------------------------------------------------
    City                 |    NORTH CHARLESTON
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29406-9171
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    843-797-6600
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    150 NEWTON RD 
-----------------------------------------------------
    City                 |    SUMMERVILLE
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29483-9349
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    801-347-1662
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    208800000X
-----------------------------------------------------
    Taxonomy Name        |    Urology Physician
-----------------------------------------------------
    License Number       |    1699759563
-----------------------------------------------------
    License Number State |    SC
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.