Provider Demographics
NPI:1912106071
Name:CAMACHO, GERMAN (MD)
Entity Type:Individual
Prefix:
First Name:GERMAN
Middle Name:
Last Name:CAMACHO
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:BESF
Mailing Address - Street 2:APO AE 09348
Mailing Address - City:BAGHDAD
Mailing Address - State:INTERNATIONAL ZONE
Mailing Address - Zip Code:09348
Mailing Address - Country:IQ
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COND CAGUAS TOWER
Practice Address - Street 2:APT 1208
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5604
Practice Address - Country:US
Practice Address - Phone:787-649-5258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16108208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice