Provider Demographics
NPI:1396702247
Name:COLE, CAMERON WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:WILLIAM
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8239 NEW CUT RD
Mailing Address - Street 2:
Mailing Address - City:CAMPOBELLO
Mailing Address - State:SC
Mailing Address - Zip Code:29322-8733
Mailing Address - Country:US
Mailing Address - Phone:864-473-1949
Mailing Address - Fax:
Practice Address - Street 1:101 E WOOD ST
Practice Address - Street 2:SPARTANBURG REGIONAL MEDICAL CENTER
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6288
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC213072080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT52350Medicare UPIN