Provider Demographics
NPI:1902809478
Name:LUO, CAMERON S (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:S
Last Name:LUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SU
Other - Middle Name:
Other - Last Name:LUO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5120 CHARLESTON ROAD
Mailing Address - Street 2:SUITE #5
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9497
Mailing Address - Country:US
Mailing Address - Phone:812-725-8621
Mailing Address - Fax:812-725-8696
Practice Address - Street 1:5120 CHARLESTON ROAD
Practice Address - Street 2:SUITE #5
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9497
Practice Address - Country:US
Practice Address - Phone:812-725-8621
Practice Address - Fax:812-725-8696
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY386502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INH26219Medicare UPIN
KY00620001Medicare PIN