Provider Demographics
NPI:1043409444
Name:STEFFEN CAMERON ET ALL
Entity Type:Organization
Organization Name:STEFFEN CAMERON ET ALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEFFEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-602-7531
Mailing Address - Street 1:551 WABASH AVE NW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-4143
Mailing Address - Country:US
Mailing Address - Phone:330-602-7531
Mailing Address - Fax:
Practice Address - Street 1:551 WABASH AVE NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-4143
Practice Address - Country:US
Practice Address - Phone:330-602-7531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9315731Medicare PIN