Provider Demographics
NPI:1922991751
Name:CLEVELAND, CAMRON NASHAWN
Entity type:Individual
Prefix:
First Name:CAMRON
Middle Name:NASHAWN
Last Name:CLEVELAND
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 1:3901 MERRIFIELD DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY GRANDE
Mailing Address - State:AL
Mailing Address - Zip Code:36703-2730
Mailing Address - Country:US
Mailing Address - Phone:334-407-0443
Mailing Address - Fax:
Practice Address - Street 1:3901 MERRIFIELD DR
Practice Address - Street 2:
Practice Address - City:VALLEY GRANDE
Practice Address - State:AL
Practice Address - Zip Code:36703-2730
Practice Address - Country:US
Practice Address - Phone:334-407-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program