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NPI Code Detail

MEDICARE: CAMERON ALLEN SHROUT

MEDICARE: CAMERON ALLEN SHROUT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRP0012692WV

General Provider Information

NPI Number : 1043964299
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMERON ALLEN SHROUT
Provider Business Mailing Address
First Line : 200 EMILY DR
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-5500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 EMILY DR
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-5500
Country : US
Telephone Number : 304-918-6056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2022
Last Update Date : 02/07/2022

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Directions to “ CAMERON ALLEN SHROUT ” Practice Location

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