Individual
CAMI ANN BERTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
380 WOODS COVE RD, SCOTTSBORO, AL 35768-2428
(256) 259-4444
Mailing address
380 WOODS COVE RD, SCOTTSBORO, AL 35768-2428
(256) 259-4444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.772
AL
363A00000X
Physician Assistant
PA1375
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158202
—
AL
01
—
511-46004
BLUE CROSS/BLUE SHIELD OF ALABAMA
AL
01
—
7203722930
DOT NATIONAL REGISTRY
AL
01
—
772-4235
QACSC
AL
01
—
PA.772
LICENSE
AL
01
—
PA1375
LICENSE
TN
Enumeration date
08/30/2007
Last updated
03/07/2023
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