Provider Demographics
NPI:1134417256
Name:CAMERLIN, BRIAN M (PHARMD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:CAMERLIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 WELLS ST
Mailing Address - Street 2:
Mailing Address - City:SISTERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26175-1323
Mailing Address - Country:US
Mailing Address - Phone:304-615-7856
Mailing Address - Fax:
Practice Address - Street 1:615 WELLS ST
Practice Address - Street 2:
Practice Address - City:SISTERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26175-1323
Practice Address - Country:US
Practice Address - Phone:304-615-7856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228268183500000X
WVRP0006856183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist