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NPI Code Detail

MEDICARE: DAVID J CLAIN MD

MEDICARE:   DAVID J CLAIN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician138832NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114902343
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID J CLAIN MD
Provider Business Mailing Address
First Line : PO BOX 32886
Second Line : BETH ISRAEL MEDICAL CENTER, DEPT OF GASTROENTEROLOGY
City : HARTFORD
State : CT
Zip : 06150-2886
Country : US
Telephone Number : 212-420-4521
Fax Number : 212-420-4373
Provider Business Practice Location Address
First Line : 10 UNION SQUARE E
Second Line : #2G, PHILLIPS AMBULATORY CARE CENTER
City : NEW YORK
State : NY
Zip : 10003-3801
Country : US
Telephone Number : 212-420-4521
Fax Number : 212-420-4373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 07/08/2007

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