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General NPI Number Information
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NPI Number | 1497129258
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Entity Type | Organization
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Legal Business Name | MICHAEL E CLIFFORD M D PROF CORP
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 11/25/2015
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Provider Practice Location Address
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Address Line | 7151 CASCADE VALLEY CT SUITE 103
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City | LAS VEGAS
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State | NV
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Zip | 89128-0496
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Country | US
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Telephone | 702-944-5444
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Fax | 702-944-4322
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Provider Business Mailing Address
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Address Line | 7151 CASCADE VALLEY CT SUITE 103
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City | LAS VEGAS
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State | NV
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Zip | 89128-0496
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Country | US
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Telephone | 702-944-5444
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Fax | 702-944-4322
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL E CLIFFORD
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Credential | M.D.
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Telephone | 702-944-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 5960
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License Number State | NV
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