Individual
DR. CARL F CLAVENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 S ADAMS RD, STE 200, BIRMINGHAM, MI 48009-6863
(248) 646-3733
(248) 642-2566
Mailing address
600 S ADAMS RD, STE 200, BIRMINGHAM, MI 48009-6863
(248) 646-3733
(248) 642-2566
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301054362
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101441
CARE CHOICES PIN
MI
01
—
180F321870
BLUE CROSS GROUP NUMBER
MI
01
—
C4110
M-CARE ID #
MI
01
—
F48420
HAP PIN #
MI
01
—
G5031F
BLUE CARE NETWORK GROUP #
MI
Enumeration date
06/21/2005
Last updated
11/17/2021
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