Provider Demographics
NPI:1891448619
Name:CAMARA, ISMAIL (DC)
Entity Type:Individual
Prefix:DR
First Name:ISMAIL
Middle Name:
Last Name:CAMARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 PENNY POINT PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8569
Mailing Address - Country:US
Mailing Address - Phone:704-605-5069
Mailing Address - Fax:
Practice Address - Street 1:5200 PARK RD STE 117
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3669
Practice Address - Country:US
Practice Address - Phone:704-703-5232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5316111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor