Healthcare Provider Details

I. General information

NPI: 1568308435
Provider Name (Legal Business Name): CLINICAL ASSOCIATES P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1838 GREENE TREE RD STE 320
PIKESVILLE MD
21208-6391
US

IV. Provider business mailing address

515 FAIRMOUNT AVE
TOWSON MD
21286-5466
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-3990
  • Fax:
Mailing address:
  • Phone: 410-494-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEWEL WATSON
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 410-494-1237