Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 031202 | GA |
N | 207N00000X | Dermatologist | 74873 | MA |
NPI | 1023086899 |
---|---|
Provider Name | Dr. Rebecca B Campen |
First Address | Savannah, GA 31405-4601 |
Second Address | Savannah, GA 31405-4601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 26/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3093034 | (05) | MA |
724676 | TUFTS HEALTH PLAN (01) | MA |
E16137 | (02) | |
J12489 | BCBS MA (01) | MA |