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Individual
DR. CLARENCE LESLIE POWELL JR.
Active
Individual
DR. CLARENCE LESLIE POWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101027857
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005666805
—
VA
01
—
0101027857
STATE MEIDCAL LICENSE
VA
Enumeration date
02/03/2006
Last updated
05/17/2010
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