Provider Demographics
NPI:1619460011
Name:BRASSFIELD, CAMERON WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:WILLIAM
Last Name:BRASSFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:POLLOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28573-0068
Mailing Address - Country:US
Mailing Address - Phone:252-635-3906
Mailing Address - Fax:252-224-0378
Practice Address - Street 1:532 WEBB BLVD
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-2042
Practice Address - Country:US
Practice Address - Phone:252-447-7088
Practice Address - Fax:252-447-2752
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2025-00288207Q00000X
171000000X
VA0102205870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No171000000XOther Service ProvidersMilitary Health Care Provider