Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 0101238243 | VA |
N | 207XS0117X | Orthopaedic Spine Surgeon | 0101238243 | VA |
NPI | 1255398749 |
---|---|
Provider Name | David Clifford |
First Address | Virgina Beach, VA 23462 |
Second Address | Virginia Beach, VA 23454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 08/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86614 | (02) |