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Organization

IAN R CAMERON MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IAN RICHARD CAMERON MD (PRESIDENT)
(860) 657-3602
Entity
Organization

Contact information

Practice address
2174 MAIN ST, GLASTONBURY, CT 06033-2206
(860) 657-3602
(860) 657-4421
Mailing address
2174 MAIN ST, GLASTONBURY, CT 06033-2206
(860) 657-3602
(860) 657-4421

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
011816
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1568404242
INDIVIDUAL PROVIDER NPI
CT
Enumeration date
11/18/2009
Last updated
11/18/2009
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