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NPI Code Detail

MEDICARE: DR. EDWIN L CLONTS MD

MEDICARE:  DR. EDWIN L CLONTS  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
1207Q00000XFamily Medicine Physician23309MN
2207Q00000XFamily Medicine Physician0522MP

General Provider Information

NPI Number : 1619955549
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWIN L CLONTS MD
Provider Business Mailing Address
First Line : PO BOX 502878
Second Line :
City : SAIPAN
State : MP
Zip : 96950-2878
Country : US
Telephone Number : 670-234-2901
Fax Number : 670-234-2906
Provider Business Practice Location Address
First Line : KULOT DI ROSA DR. CHALAN KIYA
Second Line : HEALTH PROFESSIONAL CORPORATION
City : SAIPAN
State : MP
Zip : 96950-2878
Country : US
Telephone Number : 670-234-2901
Fax Number : 670-234-2906
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 09/12/2012

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Directions to “ DR. EDWIN L CLONTS MD” Practice Location

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