Provider Demographics
NPI:1972922524
Name:KAMILARIS, CRYSTAL DAWN CHRYSAVGI (MD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL DAWN
Middle Name:CHRYSAVGI
Last Name:KAMILARIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:BLDG 10, CRC RM 1-3330 10 CENTER DRIVE MSC 1109
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-402-3699
Mailing Address - Fax:301-480-4914
Practice Address - Street 1:NIH 10 CENTER DRIVE BUILDING 10, ROOM 1-3330
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-2527
Practice Address - Country:US
Practice Address - Phone:301-402-3699
Practice Address - Fax:301-480-4914
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY300586207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program