Provider Demographics
NPI:1154558583
Name:CAMAC, ERIN RILEY (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:RILEY
Last Name:CAMAC
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ANN
Other - Last Name:NAREWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-707-5864
Mailing Address - Fax:215-707-6867
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-5103
Practice Address - Country:US
Practice Address - Phone:859-323-9057
Practice Address - Fax:859-323-9502
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT 013262207R00000X
PAOS016690207RC0200X, 207RP1001X
KYTP601207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS016690OtherUNRESTRICTED LICENCE # OS016690
PAOS016690OtherUNRESTRICTED LICENCE # OS016690