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General NPI Number Information
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NPI Number | 1255493086
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Entity Type | Individual
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Provider Name | MARY B. ROSE CLIFTON MD
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Gender | Female
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 2418 BARSTOW RD
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City | LANSING
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State | MI
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Zip | 48906-3774
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Country | US
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Telephone | 231-342-6132
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Fax |
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Provider Business Mailing Address
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Address Line | 121 READE ST APT 2B
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City | NEW YORK
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State | NY
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Zip | 10013-6305
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Country | US
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Telephone | 231-342-6132
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301065488
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License Number State | MI
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