Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 2017010076 | MO |
NPI | 1003250606 |
---|---|
Provider Name | Dr. Manuel David Camejo |
First Address | Leawood, KS 66211-1669 |
Second Address | Kansas City, MO 64111-5954 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2013 |
Last Update Date | 08/07/2019 |