MEDICARE: DR. RONALD E CLEMENT M.D.

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
1	208600000X	Surgery Physician	D0071015	MD

General Provider Information

NPI Number	:	1407841786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD E CLEMENT M.D.

Provider Business Mailing Address
First Line	:	7505 OSLER DR
Second Line	:	SUITE 303
City	:	TOWSON
State	:	MD
Zip	:	21204-7736
Country	:	US
Telephone Number	:	410-427-5438
Fax Number	:	410-427-2291

Provider Business Practice Location Address
First Line	:	7505 OSLER DR
Second Line	:	SUITE 303
City	:	TOWSON
State	:	MD
Zip	:	21204-7736
Country	:	US
Telephone Number	:	410-427-2271
Fax Number	:	410-427-2291

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	06/10/2011

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