Provider Demographics
NPI:1417137522
Name:CAMERON, TAMMY M (RD, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:M
Last Name:CAMERON
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:THOROFARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-0605
Mailing Address - Country:US
Mailing Address - Phone:856-628-0876
Mailing Address - Fax:856-845-8673
Practice Address - Street 1:791 STERLING RD
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-4014
Practice Address - Country:US
Practice Address - Phone:856-628-0876
Practice Address - Fax:856-845-8673
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD854262133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered