Provider Demographics
NPI:1689326639
Name:STEWART-CAMPS, MELINDA DESHAWN
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:DESHAWN
Last Name:STEWART-CAMPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:STEWART-CAMPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:116 E MAIN ST # 201
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4540
Mailing Address - Country:US
Mailing Address - Phone:803-560-8040
Mailing Address - Fax:
Practice Address - Street 1:454 ANDERSON RD S
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3392
Practice Address - Country:US
Practice Address - Phone:888-627-5224
Practice Address - Fax:803-526-7064
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker