Provider Demographics
NPI:1023162120
Name:DUNHAM, CAMI J (PHYSICIANS ASST)
Entity type:Individual
Prefix:MS
First Name:CAMI
Middle Name:J
Last Name:DUNHAM
Suffix:
Gender:M
Credentials:PHYSICIANS ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 BAYVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306
Mailing Address - Country:US
Mailing Address - Phone:954-771-2551
Mailing Address - Fax:954-771-2772
Practice Address - Street 1:3000 BAYVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306
Practice Address - Country:US
Practice Address - Phone:954-771-2551
Practice Address - Fax:954-771-2772
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101044363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE4166ZMedicare ID - Type Unspecified
FLX19637Medicare UPIN