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NPI Code Detail

MEDICARE: DR. CLIFFORD C CLOONAN MD

MEDICARE: DR. CLIFFORD C CLOONAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD423158PA
2207P00000XEmergency Medicine PhysicianMD423158PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003854753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLIFFORD C CLOONAN MD
Provider Business Mailing Address
First Line : 409 S 2ND ST
Second Line : SUITE 2F
City : HARRISBURG
State : PA
Zip : 17104-1612
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6481 CARLISLE PIKE
Second Line :
City : MECHANICSBURG
State : PA
Zip : 17050-2377
Country : US
Telephone Number : 717-516-6396
Fax Number : 717-620-8093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 01/26/2018

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