Provider Demographics
NPI:1083682645
Name:JORDAN, CAMI U (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMI
Middle Name:U
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:324 LOUISA AVE
Mailing Address - Street 2:STE 118
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4669
Mailing Address - Country:US
Mailing Address - Phone:757-333-7797
Mailing Address - Fax:757-333-7760
Practice Address - Street 1:324 LOUISA AVE
Practice Address - Street 2:STE 118
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4669
Practice Address - Country:US
Practice Address - Phone:757-333-7797
Practice Address - Fax:757-333-7760
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101057968208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVAA113084Medicare PIN
VAH15395Medicare UPIN