Provider Demographics
NPI:1134292576
Name:CAMPOS, FERNANDO ARTURO (PT, MSPT)
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:ARTURO
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412307
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5818
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:16260 BENNETT RD
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4630
Practice Address - Country:US
Practice Address - Phone:540-727-0737
Practice Address - Fax:540-727-0738
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214128225100000X
DCPT870715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD20545OtherPT LICENSE #
DC870715OtherPT LICENSE #
DC870715OtherPT LICENSE #
DCG02816Medicare PIN