Provider Demographics
NPI:1457356248
Name:CAMP, SEAN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:CAMP
Suffix:
Gender:M
Credentials:DC
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 23
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-0023
Mailing Address - Country:US
Mailing Address - Phone:330-682-6876
Mailing Address - Fax:330-683-0836
Practice Address - Street 1:345 S CROWN HILL RD
Practice Address - Street 2:
Practice Address - City:ORRVILLE
Practice Address - State:OH
Practice Address - Zip Code:44667-9527
Practice Address - Country:US
Practice Address - Phone:330-682-6876
Practice Address - Fax:330-683-0836
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH44-00292OtherUNITED HEALTHCARE
OH0961973Medicaid
OHQ012521OtherHOMETOWN HEALTH PLAN
OH000000127706OtherANTHEM BC/BS
OH341127452027Medicaid
OHQ012521OtherHOMETOWN HEALTH PLAN
OHCA0757661Medicare ID - Type UnspecifiedMEDICARE