Basic Information
| Provider Information | |||||||||
| NPI: | 1760423933 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPER | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | SA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55310 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057319701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 19TH STREET SOUTH | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059344011 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 03/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | PA-225 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 009972650 | 05 | AL | MEDICAID | 051503493 | 01 | AL | BLUE CROSS | OTHER | 051505531 | 01 | AL | BLUE CROSS | OTHER | 051529629 | 01 | AL | BLUE CROSS | OTHER | 051503493 | 05 | AL | MEDICAID | 009932504 | 05 | AL | MEDICAID | 970022064 | 01 | AL | RAILROAD MEDICARE | OTHER | 051503494 | 01 | AL | BLUE CROSS | OTHER |