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NPI Code Detail

MEDICARE: DR. CAROLE VAN CAMP

MEDICARE: DR. CAROLE VAN CAMP
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1710498365
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLE VAN CAMP
Provider Business Mailing Address
First Line : 5308 BERETTA WAY
Second Line :
City : WILMINGTON
State : NC
Zip : 28409-2837
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 720 SAINT JAMES DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-2937
Country : US
Telephone Number : 910-616-4707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2017
Last Update Date : 10/22/2017

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Directions to “ DR. CAROLE VAN CAMP ” Practice Location

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