Provider Demographics
NPI:1588052260
Name:CAMARA, ABRAHAM
Entity type:Individual
Prefix:MR
First Name:ABRAHAM
Middle Name:
Last Name:CAMARA
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 1:9295 JACKIES BND
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-9104
Mailing Address - Country:US
Mailing Address - Phone:614-381-8491
Mailing Address - Fax:
Practice Address - Street 1:9295 JACKIES BND
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-9104
Practice Address - Country:US
Practice Address - Phone:614-381-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0073198Medicaid