Provider Demographics
NPI:1528692100
Name:REAVES, CAMERON JAMES (PA)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:JAMES
Last Name:REAVES
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 1:2080 ENERGY DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-8722
Mailing Address - Country:US
Mailing Address - Phone:919-328-5573
Mailing Address - Fax:984-235-1617
Practice Address - Street 1:2080 ENERGY DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-8722
Practice Address - Country:US
Practice Address - Phone:919-328-5573
Practice Address - Fax:984-235-1617
Is Sole Proprietor?:No
Enumeration Date:2020-02-23
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program