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Individual

JAVIER L CLEMENTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18099 LORAIN RD, STE 316, CLEVELAND, OH 44135
(216) 671-2322
(216) 671-0140
Mailing address
18099 LORAIN AVE, STE 316, CLEVELAND, OH 44111
(216) 671-2322
(216) 671-0140

Taxonomy

Speciality
Code
Description
License number
State
246ZN0300X
Nephrology Specialist/Technologist
Primary
35041323
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000130134
ANTHEM
05
0366223
OH
01
0560460014
BWC
01
12812
QUALCHOICE
Enumeration date
09/26/2006
Last updated
07/08/2007
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