Provider Demographics
NPI:1033294392
Name:NEMECEK, CAMERON JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:JOHN
Last Name:NEMECEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4719 SHELBURNE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-5677
Mailing Address - Country:US
Mailing Address - Phone:701-223-5001
Mailing Address - Fax:701-223-4709
Practice Address - Street 1:4719 SHELBURNE ST STE 7
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503
Practice Address - Country:US
Practice Address - Phone:701-223-5001
Practice Address - Fax:701-223-4709
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2942111N00000X
ND048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND18812OtherBCBS OF ND
ND16241Medicaid
ND18812OtherBCBS OF ND
ND16241Medicaid
T89012Medicare UPIN