Provider Demographics
NPI:1922449487
Name:CAMERER, MOLLY KATHERINE (OD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:KATHERINE
Last Name:CAMERER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 RIDGEWAY DR SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-4244
Mailing Address - Country:US
Mailing Address - Phone:319-899-4863
Mailing Address - Fax:
Practice Address - Street 1:576 BOYSON RD NE
Practice Address - Street 2:SUITE 104
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7363
Practice Address - Country:US
Practice Address - Phone:319-396-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002594152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist