Individual
CAMERON RAYMOND NISWANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
US HWY 491 N, SHIPROCK, NM 87420-9998
(505) 368-6001
(505) 368-6025
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-6025
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD61486397
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
10/31/2024
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