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NPI Code Detail

MEDICARE: DR. MICHELE RENE CLEMENT MD

MEDICARE:  DR. MICHELE RENE CLEMENT  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
1208800000XUrology PhysicianMA07578100NJ
22088P0231XPediatric Urology PhysicianMD070907LPA

General Provider Information

NPI Number : 1780677872
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELE RENE CLEMENT MD
Provider Business Mailing Address
First Line : PO BOX 783311
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-3311
Country : US
Telephone Number : 484-884-4500
Fax Number : 484-884-0699
Provider Business Practice Location Address
First Line : 1210 S CEDAR CREST BLVD
Second Line : SUITE 1100
City : ALLENTOWN
State : PA
Zip : 18103-6229
Country : US
Telephone Number : 610-402-7999
Fax Number : 610-402-7995
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 11/13/2015

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Directions to “ DR. MICHELE RENE CLEMENT MD” Practice Location

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