Individual
MICHAEL CLIFFORD CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
13207 RAVENNA RD, SENIOR ASSESSMENT PROGRAM, CHARDON, OH 44024-7032
(216) 844-2400
(440) 285-6247
Mailing address
24701 EUCLID AVE, THIRD FLOOR BILLING SERVICES, EUCLID, OH 44117-1714
(216) 844-2400
(440) 285-6247
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34008772
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2854817
—
OH
Enumeration date
11/08/2006
Last updated
05/20/2014
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