Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 2404 | MT |
Y | 1223G0001X | General Practice | 7303 | NE |
Y | 213EG0000X | General Practice | 7303 | NE |
NPI | 1497076079 |
---|---|
Provider Name | Cameron James Thomas |
First Address | Bellevue, NE 68005-3639 |
Second Address | Bellevue, NE 68005-3639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 25/01/2017 |