Provider Demographics
NPI:1154459428
Name:BILLER, CAMERON MCKENNA (PA)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:MCKENNA
Last Name:BILLER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 DORIC AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-2903
Mailing Address - Country:US
Mailing Address - Phone:401-562-8313
Mailing Address - Fax:401-467-9030
Practice Address - Street 1:2756 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3077
Practice Address - Country:US
Practice Address - Phone:401-384-6007
Practice Address - Fax:401-773-7878
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00215363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI3025699OtherBLUECROSS PIN NO
RI405344OtherBLUECHIP PIN NO
RI405344OtherBLUECHIP PIN NO