Healthcare Provider Details

I. General information

NPI: 1053395905
Provider Name (Legal Business Name): CHRISTOPHER M CLIFFORD CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31519 WINTERPLACE PKWY STE 3
SALISBURY MD
21804-1894
US

IV. Provider business mailing address

508 W COLLEGE AVE
SALISBURY MD
21801-6129
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-2500
  • Fax: 443-250-2454
Mailing address:
  • Phone: 443-235-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR118456
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: