Provider Demographics
NPI:1114407442
Name:MILLS, CAMERON J
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:J
Last Name:MILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7553 NORTHAM DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-8716
Mailing Address - Country:US
Mailing Address - Phone:937-689-1518
Mailing Address - Fax:
Practice Address - Street 1:7553 NORTHAM DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-8716
Practice Address - Country:US
Practice Address - Phone:937-689-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program