Healthcare Provider Details

I. General information

NPI: 1649219957
Provider Name (Legal Business Name): DAVID M CLAMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 MARIGOLD DR NE
ALBUQUERQUE NM
87122-1128
US

IV. Provider business mailing address

1209 MARIGOLD DR NE
ALBUQUERQUE NM
87122-1128
US

V. Phone/Fax

Practice location:
  • Phone: 505-797-0212
  • Fax:
Mailing address:
  • Phone: 505-797-0212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD21131
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: