Individual
RODERICK CLAYBROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
4301074231
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024520
MIDWEST
MI
01
—
12897
CAPE
MI
01
—
141817
CARE CHOICES
MI
01
—
150941
GREAT LAKES
MI
01
—
17348
MCARE
MI
05
—
4781570
—
MI
01
—
59938
OMNICARE
MI
01
—
607926000
OCWP
MI
01
—
630511
BLUE CROSS NETWORK
MI
01
—
7542611
AETNA
MI
01
—
P00271654
RDMC
MI
01
—
RC074231
BCBS
MI
01
—
TAX I.D.
20-0440211
MI
Enumeration date
08/31/2005
Last updated
07/08/2007
Update your record
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