Provider Demographics
NPI:1962618330
Name:MACEWEN, CAMERON C (DC)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:C
Last Name:MACEWEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1045
Mailing Address - Country:US
Mailing Address - Phone:508-698-0688
Mailing Address - Fax:508-698-0621
Practice Address - Street 1:211 NORTH ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1045
Practice Address - Country:US
Practice Address - Phone:508-698-0688
Practice Address - Fax:508-698-0621
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35981Medicare PIN