Provider Demographics
NPI:1316506751
Name:FITCH, CAMERON
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:FITCH
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 1:1728 STARTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-9696
Mailing Address - Country:US
Mailing Address - Phone:704-472-8638
Mailing Address - Fax:
Practice Address - Street 1:3971 RIVER POINTE PL APT 3E
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8153
Practice Address - Country:US
Practice Address - Phone:704-472-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program