Dr. Bertram Clifford Providence
Adult Reconstructive Orthopaedic Surgeon
18th Medcom Attn: Dccs-Qm (credentials)
New Island City
, New Island 96205-0054
Dr. Bertram Clifford Providence
Adult Reconstructive Orthopaedic Surgeon
18th Medcom Attn: Dccs-Qm (credentials)
New Island City
, New Island 96205-0054
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About
Features
Specialties
- Adult Reconstructive Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Bertram Clifford Providence
- Hq 2id Attn: Dso Unit 15041
- Apo, AP
- Zip : 96258
- Phone :
Second Address
- Dr. Bertram Clifford Providence
- 18th Medcom Attn: Dccs-Qm (credentials)
- Apo, AP
- Zip : 96205-0054
- Phone : 011-822-7916-6027
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD-11256 | HI |
National Provider Identifier
| NPI | 1174512057 |
|---|---|
| Provider Name | Dr. Bertram Clifford Providence |
| First Address | Apo, AP 96258 |
| Second Address | Apo, AP 96205-0054 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/10/2005 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.