Provider Demographics
NPI:1477578011
Name:CAMISHION, GERMAINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:GERMAINE
Middle Name:M
Last Name:CAMISHION
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GERMAINE
Other - Middle Name:M
Other - Last Name:CAMISHION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:110 MARTER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3124
Mailing Address - Country:US
Mailing Address - Phone:856-235-6565
Mailing Address - Fax:856-235-6566
Practice Address - Street 1:110 MARTER AVE STE 102
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3124
Practice Address - Country:US
Practice Address - Phone:856-235-6565
Practice Address - Fax:856-235-6566
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA54599207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D87122Medicare UPIN
CA611098Medicare ID - Type Unspecified