Provider Demographics
NPI:1275844573
Name:CAMPBELL, CALEB R (MD)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:R
Last Name:CAMPBELL
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 1:5900 CORPORATE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-7005
Mailing Address - Country:US
Mailing Address - Phone:412-369-4000
Mailing Address - Fax:412-369-7667
Practice Address - Street 1:5900 CORPORATE DR STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7005
Practice Address - Country:US
Practice Address - Phone:412-369-4000
Practice Address - Fax:412-369-7667
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI14238207X00000X
TXBP1 0030785207X00000X
PAMD461204207XS0106X, 207X00000X
NH16661207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICC93502Medicaid
RI003280901Medicare PIN