Individual
CLIFFORD N OWHOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
15400 W MCNICHOLS RD, DETROIT, MI 48235-3724
(131) 416-6262
Mailing address
15400 W MCNICHOLS RD, DETROIT, MI 48235-3724
(313) 416-6262
(855) 643-6164
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002432
MI
363AS0400X
Surgical Physician Assistant
5601002432
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316135379
—
MI
Enumeration date
10/04/2007
Last updated
12/16/2022
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