Provider Demographics
NPI:1033134556
Name:CAMERON, NADIA G (MD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:G
Last Name:CAMERON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 WOODLAND PARK CIR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-1419
Mailing Address - Country:US
Mailing Address - Phone:321-279-3100
Mailing Address - Fax:
Practice Address - Street 1:212 EDGEWOOD AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3027
Practice Address - Country:US
Practice Address - Phone:404-525-9946
Practice Address - Fax:404-525-9949
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009959205Medicaid
AL051518980OtherBLUE CROSS BLUE SHIELD
AL051517483Medicare ID - Type Unspecified
AL009959205Medicaid