MEDICARE: CAMILLE E. TAWIL M.D.

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
1	207R00000X	Internal Medicine Physician	D68176	MD
2	207R00000X	Internal Medicine Physician	35082765T	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	150888ZDKA	OTHER	MD	MEDICARE
7	P00736743	OTHER	GA	RAILROAD MEDICARE
12	494786	OTHER	MD	MEDICARE UPIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1144225053	OTHER		AETNA PPO
2	S206 0002	OTHER	DC	CAREFIRST
4	1144225053	OTHER		AETNA HMO
5	419760700	OTHER	MD	MEDICAL ASSISTANCE
6	209064	OTHER		EHP/JHH
8	1144225053	OTHER		CIGNA/GREAT-WEST HEALTHCARE
9	1144225053	OTHER		NCPPO
10	95047501	OTHER	MD	CAREFIRST
11	1144225053	OTHER		MEDSTAR FAMILY CHOICE

General Provider Information

NPI Number	:	1144225053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE E. TAWIL M.D.

Provider Business Mailing Address
First Line	:	3730 FALLS RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-1844
Country	:	US
Telephone Number	:	410-235-0999
Fax Number	:	877-423-2298

Provider Business Practice Location Address
First Line	:	3730 FALLS RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-1844
Country	:	US
Telephone Number	:	410-235-0999
Fax Number	:	877-423-2298

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	11/08/2011

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