Provider Demographics
NPI:1831352020
Name:CAMDEN, JEREMY RYAN (MD)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:RYAN
Last Name:CAMDEN
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 1:1554 RIVER BIRCH RUN N
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-7500
Mailing Address - Country:US
Mailing Address - Phone:757-671-1144
Mailing Address - Fax:757-671-1152
Practice Address - Street 1:1554 RIVER BIRCH RUN N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-7500
Practice Address - Country:US
Practice Address - Phone:757-671-1144
Practice Address - Fax:757-671-1152
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00754832085R0202X
VA01012464112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology