Individual
MARK L CAMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3210 LEGACY CT, WEST BLOOMFIELD, MI 48323-3634
(855) 687-7237
(855) 673-9190
Mailing address
22100 BOTHELL EVERETT HWY, BOTHELL, WA 98021-8431
(208) 416-2932
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101266424
VA
2085R0202X
Diagnostic Radiology Physician
Primary
4301069865
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3102510972
BCBSM
MI
05
—
4606589
—
MI
05
—
4606598
—
MI
05
—
4606613
—
MI
05
—
4606622
—
MI
Enumeration date
07/04/2006
Last updated
07/20/2023
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