Provider Demographics
NPI:1407827256
Name:CAMERON, ALISON GILLMOR (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:GILLMOR
Last Name:CAMERON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:BOGUE
Other - Last Name:GILLMOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2057
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891
Mailing Address - Country:US
Mailing Address - Phone:401-596-7477
Mailing Address - Fax:401-596-0821
Practice Address - Street 1:25 WELLS ST
Practice Address - Street 2:THE WESTERLY HOSPITAL
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891
Practice Address - Country:US
Practice Address - Phone:401-348-3383
Practice Address - Fax:401-348-3792
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI11343207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9003480Medicaid
H59232Medicare UPIN