Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101039382 | VA |
N | 2080P0214X | Pediatric Pulmonologist | 0101039382 | VA |
N | 2080P0214X | Pediatric Pulmonologist | D0060604 | MD |
N | 2080P0214X | Pediatric Pulmonologist | MD32937 | DC |
NPI | 1427014984 |
---|---|
Provider Name | Dr. James Ernest Clayton |
First Address | Baltimore, MD 21297-3174 |
Second Address | Fairfax, VA 22031-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 29/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6700250 | (05) | VA |
6707084 | (05) | VA |
6710999 | (05) | VA |
6720544 | (05) | VA |
6720561 | (05) | VA |
F62165 | (02) |