Provider Demographics
NPI:1437106572
Name:PARSA, CAMERON FARROKH (MD)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:FARROKH
Last Name:PARSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5264
Mailing Address - Fax:608-833-6965
Practice Address - Street 1:2880 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3644
Practice Address - Country:US
Practice Address - Phone:608-263-6414
Practice Address - Fax:608-263-1466
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD52004207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD680471300Medicaid
MDG49261Medicare UPIN
MD680471300Medicaid
MD792TMedicare ID - Type UnspecifiedINDIVIDUAL