Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 016864 | ME |
Y | 208600000X | Surgeon | 016864 | ME |
N | 2086S0105X | Surgery of the Hand | 016864 | ME |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD443747 | PA |
NPI | 1114035995 |
---|---|
Provider Name | Mr. Richard Brannon Claytor |
First Address | Bryn Mawr, PA 19010-3131 |
Second Address | Bryn Mawr, PA 19010-3131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
431882299 | (05) | ME |
H22862 | (02) |