Provider Demographics
NPI:1568574184
Name:MAILE, CAMERON JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:JAMES
Last Name:MAILE
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 1:1109 BARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7580
Mailing Address - Country:US
Mailing Address - Phone:843-388-0995
Mailing Address - Fax:
Practice Address - Street 1:9330 MEDICAL PLAZA DRIVE
Practice Address - Street 2:TRIDENT MEDICAL CENTER
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-797-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18899207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC188996Medicaid
G654112986Medicare PIN
G654112987Medicare PIN
SCG65411Medicare UPIN
SC930117664Medicare PIN