Provider Demographics
NPI:1942298880
Name:CUSHING, CAMERON C (MD)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:C
Last Name:CUSHING
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 1:1300 PICCARD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4303
Mailing Address - Country:US
Mailing Address - Phone:301-921-7900
Mailing Address - Fax:301-921-7915
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:ALEXANDRIA HOSPITAL
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3066
Practice Address - Fax:703-504-3866
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057734207P00000X
MDD0063247207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0037OtherCAREFIRST
VA006020E14Medicare ID - Type Unspecified
0037OtherCAREFIRST
VA000544E54Medicare ID - Type Unspecified
MD006020E14Medicare ID - Type Unspecified