MEDICARE: DR. CLIVE ALBERT 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	207RG0100X	Gastroenterology Physician	035800	GA

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	:	1821099987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIVE ALBERT MD

Provider Business Mailing Address
First Line	:	PO BOX 922149
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30010-2149
Country	:	US
Telephone Number	:	770-889-9901
Fax Number	:	770-889-9088

Provider Business Practice Location Address
First Line	:	1100 NORTHSIDE FORSYTH DR
Second Line	:	SUITE 330
City	:	CUMMING
State	:	GA
Zip	:	30041-6012
Country	:	US
Telephone Number	:	770-889-9901
Fax Number	:	770-889-9088

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	08/30/2012

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Directions to “ DR. CLIVE ALBERT MD” Practice Location

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