Provider Demographics
NPI:1568762045
Name:MCCAMANT, STUART R (RPH)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:R
Last Name:MCCAMANT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3268 SUPERIOR LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1916
Mailing Address - Country:US
Mailing Address - Phone:301-464-0817
Mailing Address - Fax:301-262-6377
Practice Address - Street 1:3268 SUPERIOR LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1916
Practice Address - Country:US
Practice Address - Phone:301-464-0817
Practice Address - Fax:301-262-6377
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist