Provider Demographics
NPI:1396771366
Name:GUILD, CAMERON S (MD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:S
Last Name:GUILD
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:PO BOX 2153 DEPT 1947
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35287-0002
Mailing Address - Country:US
Mailing Address - Phone:601-992-5532
Mailing Address - Fax:
Practice Address - Street 1:501 MARSHALL ST STE 104
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-1663
Practice Address - Country:US
Practice Address - Phone:601-969-6404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19382207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00462208OtherRAILROAD MEDICARE PTAN
MSP01228851OtherRR MEDICARE PTAN
MS05223367Medicaid
MS7530834OtherAETNA
MSP00350227OtherRAILROAD MEDICARE
LA1455687Medicaid
MSP00350227OtherRAILROAD MEDICARE
MSP00462208OtherRAILROAD MEDICARE PTAN
MS7530834OtherAETNA
MSI57282Medicare UPIN
MS110001984Medicare PIN