Provider Demographics
NPI:1558462085
Name:CAMPO, ARNOLD B (MD)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:B
Last Name:CAMPO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:377 RUBIN CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7275
Mailing Address - Country:US
Mailing Address - Phone:803-548-4500
Mailing Address - Fax:803-548-4566
Practice Address - Street 1:377 RUBIN CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7275
Practice Address - Country:US
Practice Address - Phone:803-548-4500
Practice Address - Fax:803-548-4566
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2017-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC15983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0641Medicaid
SCRHC127Medicaid
SC159839Medicaid
E53303Medicare UPIN
SC4754Medicare PIN
SCGP0641Medicaid