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General NPI Number Information
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NPI Number | 1831942127
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Entity Type | Organization
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Legal Business Name | CLEARALL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 907 S MAIN ST STE A
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City | HAMPSTEAD
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State | MD
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Zip | 21074-2273
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Country | US
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Telephone | 888-231-8207
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 MONTPELIER RD STE 150 MAI STOP 370
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City | LAUREL
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State | MD
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Zip | 20723-6012
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Country | US
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Telephone | 888-231-8207
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING/PRACTICE DIRECTOR
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Name | DEE E WIRTH
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Credential |
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Telephone | 667-328-9217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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