Provider Demographics
NPI:1932447919
Name:DIEUDONNE, CAMILLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:DIEUDONNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 N PARHAM RD
Mailing Address - Street 2:STE 210
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2810 N PARHAM RD
Practice Address - Street 2:STE 210
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4434
Practice Address - Country:US
Practice Address - Phone:908-220-4388
Practice Address - Fax:770-829-4028
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438653183500000X
NJ28RI03547900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist