Individual
CAMERON PHILLIP HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11700 N MERIDIAN ST, CARMEL, IN 46032-4656
(317) 688-3140
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002316A
IN
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001537485
ANTHEM PTAN
IN
05
—
300009880
—
IN
01
—
Q00147578
RAILROAD PTAN
IN
Enumeration date
07/13/2017
Last updated
05/23/2025
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