MEDICARE: CLAYTON W STRAUGHN MD PA

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	261Q00000X	Clinic/Center	D45796	MD

General Provider Information

NPI Number	:	1629159066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLAYTON W STRAUGHN MD PA

Provider Business Mailing Address
First Line	:	4404 QUEENSBURY RD STE 130
Second Line	:	COMPREHENSIVE FAMILY MEDICAL CENTER
City	:	RIVERDALE
State	:	MD
Zip	:	20737
Country	:	US
Telephone Number	:	240-260-0230
Fax Number	:	240-260-0219

Provider Business Practice Location Address
First Line	:	4404 QUEENSBURY RD STE 130
Second Line	:
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1068
Country	:	US
Telephone Number	:	240-260-0230
Fax Number	:	240-260-0219

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. CLAYTON WILBERT STRAUGHN
Credential	:	MD
Telephone Number	:	240-260-0230

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	09/16/2008

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