Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35030083 | OH |
NPI | 1003897729 |
---|---|
Provider Name | Thomas P Cliffel |
First Address | Lakewood, OH 44107-4510 |
Second Address | Lakewood, OH 44107-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 19/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0227730 | (05) | OH |