Provider Demographics
NPI:1609857994
Name:CAMP, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:CAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:310 CEDAR ST
Mailing Address - Street 2:LAUDER HALL ROOM 108
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 HOWARD AVE
Practice Address - Street 2:YALE PHYSICIANS BLDG
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-3624
Practice Address - Fax:203-785-7037
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT041547207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001415472Medicaid
H95246Medicare UPIN
CT220000626Medicare ID - Type Unspecified