Provider Demographics
NPI:1245556877
Name:CAMERON, CHRISTIAN BLAKE (MD, MBI)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:BLAKE
Last Name:CAMERON
Suffix:
Gender:M
Credentials:MD, MBI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 ERWIN RD STE 605
Mailing Address - Street 2:DIVISION OF NEPHROLOGY
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3827
Mailing Address - Country:US
Mailing Address - Phone:919-660-6860
Mailing Address - Fax:919-681-1143
Practice Address - Street 1:10207 CERNY ST
Practice Address - Street 2:SUITE 306
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4879
Practice Address - Country:US
Practice Address - Phone:919-660-6860
Practice Address - Fax:919-681-1143
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01547207RN0300X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine