Individual
DR. CAMILLO M MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1011 E NATIONAL AVE, BRAZIL, IN 47834-2713
(812) 446-3278
(812) 446-3508
Mailing address
1011 E NATIONAL AVE, BRAZIL, IN 47834-2713
(812) 446-3278
(812) 446-3508
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01049692A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200217540A
—
IN
Enumeration date
02/08/2006
Last updated
11/01/2011
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