Provider Demographics
NPI:1548845613
Name:CAMPER, PAUL MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:CAMPER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 2906
Mailing Address - City:WASHINGTON DC
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5030
Mailing Address - Country:US
Mailing Address - Phone:202-332-3846
Mailing Address - Fax:202-332-7944
Practice Address - Street 1:3131 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 2906
Practice Address - City:WASHINGTON DC
Practice Address - State:DC
Practice Address - Zip Code:20008-5030
Practice Address - Country:US
Practice Address - Phone:202-332-3846
Practice Address - Fax:202-332-7944
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4617-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical