Provider Demographics
NPI:1346543378
Name:CAMERON, RUSSELL CARLTON (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:CARLTON
Last Name:CAMERON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M351
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-7784
Mailing Address - Fax:269-341-4883
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M351
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-7784
Practice Address - Fax:269-341-4883
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY257978208000000X
MI43011023502080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics