Healthcare Provider Details

I. General information

NPI: 1184718728
Provider Name (Legal Business Name): MR. CLIFFORD LORENZO WILLIAMS V
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 HIGHLAND DR
PITTSBURGH PA
15206
US

IV. Provider business mailing address

7330 MCCLURE AVE #304
SWISSVALE PA
15218
US

V. Phone/Fax

Practice location:
  • Phone: 412-365-5201
  • Fax:
Mailing address:
  • Phone: 412-242-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: