Provider Demographics
NPI:1942509062
Name:CAMERON, DONALD GUNTER (RPH)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:GUNTER
Last Name:CAMERON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 EAST ROOSELVELT BOULAVARD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-0000
Mailing Address - Country:US
Mailing Address - Phone:704-289-5041
Mailing Address - Fax:
Practice Address - Street 1:396 E ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-0000
Practice Address - Country:US
Practice Address - Phone:704-289-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7116183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist