Provider Demographics
NPI:1447206875
Name:CAMERON, JAMES DAVID MACINTOSH III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES DAVID
Middle Name:MACINTOSH
Last Name:CAMERON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES DAVID
Other - Middle Name:MACINTOSH
Other - Last Name:CAMERON
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1632 116TH AVE NE STE C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3035
Mailing Address - Country:US
Mailing Address - Phone:425-454-8191
Mailing Address - Fax:425-454-3037
Practice Address - Street 1:1632 116TH AVE NE STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3035
Practice Address - Country:US
Practice Address - Phone:425-454-8191
Practice Address - Fax:425-454-3037
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E54580Medicare UPIN