| Doctor Name: | NICOLAS A CAMILO |
| NPI Number: | 1003834987 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | M-9357 |
| Business Practice Address: | 100 E Idaho St. Boise, ID - 83712 |
| Business Phone Number: | 2083812782 |
| Business Fax Number: | 2083813172 |
| Mailing Address: | 190 E Bannock St, BOISE |
| State: | ID |
| Postal Code: | 837126241 |
| Phone Number: | 2083812782 |
| Fax Number: | 2083813172 |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 03/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080P0207X |
| License Number: | M-9357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Pediatric Hematology-Oncology |
| Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |