Provider Demographics
NPI:1437138641
Name:SHEARER, CAMERON A SR (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:A
Last Name:SHEARER
Suffix:SR
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 1:3500 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3078
Mailing Address - Country:US
Mailing Address - Phone:615-758-5672
Mailing Address - Fax:615-758-5609
Practice Address - Street 1:3500 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3078
Practice Address - Country:US
Practice Address - Phone:615-758-5672
Practice Address - Fax:615-758-5609
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD15792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3010169Medicaid
TNA97433Medicare UPIN
TN3010167Medicare ID - Type UnspecifiedMEDICARE NUMBER