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Individual

DR. CLINZO P. MICKLE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
650 PENNSYLVANIA AVE SE, SUITE 420, WASHINGTON, DC 20003-4318
(202) 547-9001
Mailing address
2400 16TH ST NW, APT. 243, WASHINGTON, DC 20009-6646
(202) 332-2802

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD036757
DC

Other

Enumeration date
03/04/2008
Last updated
04/06/2011
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