Provider Demographics
NPI:1467665596
Name:KAMEROW, DOUGLAS BIRON (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BIRON
Last Name:KAMEROW
Suffix:
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 1:1853 MINTWOOD PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1907
Mailing Address - Country:US
Mailing Address - Phone:202-248-6900
Mailing Address - Fax:202-248-6910
Practice Address - Street 1:4151 BLADENSBURG RD
Practice Address - Street 2:FT LINCOLN FAMILY MEDICINE CENTER
Practice Address - City:COLMAR MANOR
Practice Address - State:MD
Practice Address - Zip Code:20722-1928
Practice Address - Country:US
Practice Address - Phone:301-699-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD14142207Q00000X, 2083P0500X
MDD0031197207Q00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B76766Medicare UPIN
002265F41Medicare ID - Type Unspecified