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Individual
MRS. THERESA M CAMPBELL
Active
Individual
MRS. THERESA M CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3969
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5602053
—
SD
Enumeration date
01/25/2006
Last updated
09/24/2008
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