Provider Demographics
NPI:1073576815
Name:RICHMOND INTERNAL MEDICINE AND CARDIOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:RICHMOND INTERNAL MEDICINE AND CARDIOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAMARGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-997-3313
Mailing Address - Street 1:115 MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-5203
Mailing Address - Country:US
Mailing Address - Phone:910-997-3313
Mailing Address - Fax:910-997-7904
Practice Address - Street 1:115 MALLARD LN
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-5203
Practice Address - Country:US
Practice Address - Phone:910-997-3313
Practice Address - Fax:910-997-7904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02014OtherGROUP BCBS
CB8723OtherRAILROAD MEDICARE
NC7902014Medicaid
NC02014OtherGROUP BCBS