Organization Active NPI

Luis Gabriel Camero, M.D.,P.C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Roseville, MI
National Provider Identifier
1275859290
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4301034441 Issued in MI
Legal business name
LUIS GABRIEL CAMERO, M.D.,P.C.
Practice address
25810 Kelly Rd
Suite 1
Roseville, MI 48066-4467
Phone
(586) 777-8440
Fax
(586) 777-3805
NPI assigned
Apr 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Luis Gabriel Camero, M.D.
Title
President
Phone
(586) 777-8440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X 4301034441 MI Primary

Addresses

Primary practice location

25810 Kelly Rd
Suite 1
Roseville, MI 48066-4467

Mailing address

25810 Kelly Rd
Suite 1
Roseville, MI 48066-4467
Phone (586) 777-8440

Other identifiers 2

IdentifierTypeStateIssuer
1575219MedicaidMI
43010344441OtherMIMICHIGAN LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1275859290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25810 KELLY RD",
            "address_2": "SUITE 1",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664467",
            "telephone_number": "586-777-8440",
            "fax_number": "586-777-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25810 KELLY RD",
            "address_2": "SUITE 1",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664467",
            "telephone_number": "586-777-8440",
            "fax_number": "586-777-3805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS GABRIEL CAMERO, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "CAMERO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-777-8440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301034441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1575219",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "43010344441",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.