Provider Demographics
NPI:1760403513
Name:CAMERON, PAUL F (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:CAMERON
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:PO BOX 547
Mailing Address - Street 2:CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-225-1266
Mailing Address - Fax:802-479-3548
Practice Address - Street 1:82 E VIEW LN STE 3
Practice Address - Street 2:FAMILY PSYCHIATRY ASSOCIATES
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-225-1266
Practice Address - Fax:802-479-3548
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-00085322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN0597Medicaid
VT0VN0597Medicaid
VT0VN0597Medicaid
VTRX3539Medicare PIN
VTVN059701Medicare PIN
VTOVN0597Medicaid
VTRX3539OtherMEDICARE PTAN LINKED TO CVMC MGP