Healthcare Provider Details

I. General information

NPI: 1336356880
Provider Name (Legal Business Name): CLINI CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7403A LIBERTY RD
GWYNN OAK MD
21207-3812
US

IV. Provider business mailing address

7403A LIBERTY RD
GWYNN OAK MD
21207-3812
US

V. Phone/Fax

Practice location:
  • Phone: 410-944-3337
  • Fax: 410-944-3368
Mailing address:
  • Phone: 410-944-3337
  • Fax: 410-944-3368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD0044433
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number20517
License Number StateMD

VIII. Authorized Official

Name: DR. MARK ELLIOTT WALDEN
Title or Position: OWNER PROVIDER
Credential: M.D.
Phone: 410-944-3337