Provider Demographics
NPI:1285053215
Name:STRACHAN-FORTE, CAMILLE S (MD)
Entity type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:S
Last Name:STRACHAN-FORTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CAMILLE
Other - Middle Name:SHANEE
Other - Last Name:STRACHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:655 7TH ST BLDG 700
Mailing Address - Street 2:
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:478-327-7850
Mailing Address - Fax:478-327-7816
Practice Address - Street 1:655 7TH ST BLDG 700A78
Practice Address - Street 2:
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-327-7850
Practice Address - Fax:478-327-7816
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00943208D00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice