Individual
CAMILO ALCOSEBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 OSTRUM ST, ST. LUKE'S HOSPITAL, BETHLEHEM, PA 18015-1000
(610) 954-4300
Mailing address
PO BOX 20725, LEHIGH VALLEY, PA 18002-0725
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
MD037211L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01864893
—
PA
01
—
920006466
RAILROAD MEDICARE
PA
Enumeration date
05/19/2006
Last updated
02/07/2008
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