Basic Information
| Provider Information | |||||||||
| NPI: | 1558454710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMERON | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5020 | ||||||||
| Address2: | ROXBOROUGH EMERGENCY PHYSICIAN ASSOCIATES LLC | ||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005280006 | ||||||||
| FaxNumber: | 7323499202 | ||||||||
| Practice Location | |||||||||
| Address1: | 5800 RIDGE AVE | ||||||||
| Address2: | ROXBOROUGH MEMORIAL HOSPITAL | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154874334 | ||||||||
| FaxNumber: | 7323499202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 09/24/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD030864E | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001024876 | 05 | PA | MEDICAID |