MEDICARE: CLINTON E CURTIS 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
1	207R00000X	Internal Medicine Physician	19824	WV

Other Identifiers

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

General Provider Information

NPI Number	:	1538151048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLINTON E CURTIS MD

Provider Business Mailing Address
First Line	:	PO BOX 337
Second Line	:
City	:	SCARBRO
State	:	WV
Zip	:	25917-0337
Country	:	US
Telephone Number	:	304-574-3960
Fax Number	:	304-574-2179

Provider Business Practice Location Address
First Line	:	221 W MAPLE AVE
Second Line	:
City	:	FAYETTEVILLE
State	:	WV
Zip	:	25840-1413
Country	:	US
Telephone Number	:	304-574-3960
Fax Number	:	304-574-2179

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	08/30/2011

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Directions to “ CLINTON E CURTIS MD” Practice Location

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