Provider Demographics
NPI:1558398982
Name:CAMARATA, PAUL J (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:CAMARATA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MS 3021
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-2937
Mailing Address - Country:US
Mailing Address - Phone:913-588-6122
Mailing Address - Fax:913-588-7570
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MS 3021
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-2937
Practice Address - Country:US
Practice Address - Phone:913-588-6122
Practice Address - Fax:913-588-7570
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO110222207T00000X
KS04-26166207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F49814Medicare UPIN