Provider Demographics
NPI:1235267519
Name:CAMP, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:CAMP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3455 LOCKE AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-5745
Mailing Address - Country:US
Mailing Address - Phone:817-228-4315
Mailing Address - Fax:682-316-3049
Practice Address - Street 1:3455 LOCKE AVENUE
Practice Address - Street 2:SUITE 320
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107
Practice Address - Country:US
Practice Address - Phone:817-228-4315
Practice Address - Fax:682-316-3049
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2016-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP1169208200000X, 2082S0099X, 2082S0105X
NC121464208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2972580-01Medicaid
TXTXB148028Medicare PIN
TX2972580-01Medicaid