Individual
DR. JOHANNA MARIETTA CLEWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6550 FANNIN ST, THE METHODIST, DPT OF MEDICINE, SMITH TOWER SUITE 1001, HOUSTON, TX 77030-2717
(713) 441-6722
Mailing address
6550 FANNIN ST, THE METHODIST, DPT OF MEDICINE, SMITH TOWER SUITE 1001, HOUSTON, TX 77030-2717
(713) 441-6722
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
N3568
TX
208M00000X
Hospitalist Physician
TEMPORARY LICENSE
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285864884
BLUE CROSS BLUE SHIELD
TX
05
—
2056222803
—
TX
05
—
205622801
—
TX
05
—
205622802
—
TX
01
—
8CC983
BCBS
TX
01
—
P00765636
RR MEDICARE
TX
01
—
P00896806
MEDICARE RR
TX
Enumeration date
07/17/2009
Last updated
12/16/2016
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