Provider Demographics
NPI:1114188455
Name:CAMACHO, MARC ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:ANTHONY
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-415-6400
Mailing Address - Fax:603-227-7595
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-415-6400
Practice Address - Fax:603-227-7595
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2020-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH204652086S0129X
VA01012539362086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery