Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | E6250 | AR |
N | 111NI0900X | Internist | E6250 | AR |
Y | 207RN0300X | Nephrologist | E6250 | AR |
NPI | 1053529321 |
---|---|
Provider Name | Dr. Robert R Camferdam |
First Address | Little Rock, AR 72222-7930 |
Second Address | Searcy, AR 72143-6000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2007 |
Last Update Date | 16/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
186511001 | (05) | AR |
5AH93 | (02) | AR |