Individual
MRS. CHRYSTAL G CLAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4211 VAN DYKE RD STE 101, LUTZ, FL 33558-8005
(813) 960-4026
(813) 443-8166
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 315-7496
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
168018
FL
207R00000X
Internal Medicine Physician
39577
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3331800
—
TN
05
—
64101876
—
KY
01
—
P00269713
RR MEDICARE
TN
Enumeration date
09/07/2005
Last updated
09/07/2024
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