Provider Demographics
NPI:1992235386
Name:OLEZENE, CAMERON SPENCER (MD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:SPENCER
Last Name:OLEZENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1800 LOMBARD ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1498
Mailing Address - Country:US
Mailing Address - Phone:215-893-2600
Mailing Address - Fax:215-893-2610
Practice Address - Street 1:1800 LOMBARD ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1498
Practice Address - Country:US
Practice Address - Phone:215-893-2600
Practice Address - Fax:215-893-2610
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD477845208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine