MEDICARE: CLAYMON A STEVENSON II DPM

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	213E00000X	Podiatrist	24586	MD

General Provider Information

NPI Number	:	1811996739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAYMON A STEVENSON II DPM

Provider Business Mailing Address
First Line	:	4000 ANNAPOLIS RD REAR 105
Second Line	:
City	:	HALETHORPE
State	:	MD
Zip	:	21227-3611
Country	:	US
Telephone Number	:	410-439-9185
Fax Number	:	410-355-4643

Provider Business Practice Location Address
First Line	:	4000 ANNAPOLIS RD REAR 105
Second Line	:
City	:	HALETHORPE
State	:	MD
Zip	:	21227-3611
Country	:	US
Telephone Number	:	410-355-3519
Fax Number	:	410-355-4643

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	09/02/2022

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