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Individual

CAMRON L JOHNSON PRIVITERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
5000 BRAMBLETON AVE STE B, ROANOKE, VA 24018-4642
(540) 200-8091
(540) 779-7848
Mailing address
5000 BRAMBLETON AVE STE B, ROANOKE, VA 24018-4642
(540) 200-8091
(540) 779-7848

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0102201592
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010072701
VA
01
139824
ANTHEM
VA
01
244013
SOUTHERN HEALTH
VA
01
54088505618
JOHN DEERE
VA
01
6830577
CIGNA
VA
01
7861556
AETNA
VA
Enumeration date
06/09/2005
Last updated
01/30/2026
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