Provider Demographics
NPI:1194135251
Name:BISHOP, CAMERON DEVANTE'
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:DEVANTE'
Last Name:BISHOP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4678 RILEY LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1058
Mailing Address - Country:US
Mailing Address - Phone:513-371-0798
Mailing Address - Fax:
Practice Address - Street 1:4678 RILEY LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1058
Practice Address - Country:US
Practice Address - Phone:513-371-0798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator