Provider Demographics
NPI:1124029228
Name:CAMACHO, RICARDO M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:M
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:SUMMIT MEDICAL GROUP
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:908-277-8841
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:SUMMIT MEDICAL GROUP
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-277-8625
Practice Address - Fax:908-277-8841
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA74352207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH68257Medicare UPIN
NJ060654BSDMedicare ID - Type UnspecifiedMEDICARE#