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NPI Code Detail

MEDICARE: DR. CHARLES CLEMENT MD

MEDICARE: DR. CHARLES 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
1122300000XDentist30017833OH

General Provider Information

NPI Number : 1942266994
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES CLEMENT MD
Provider Business Mailing Address
First Line : 1413 LINN ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-2605
Country : US
Telephone Number : 513-621-2727
Fax Number : 513-621-2330
Provider Business Practice Location Address
First Line : 1413 LINN ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-2605
Country : US
Telephone Number : 513-621-2727
Fax Number : 513-621-2330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 07/08/2007

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Directions to “ DR. CHARLES CLEMENT MD” Practice Location

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