Individual
DR. CHARLES CLAYTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2827 W CHELTENHAM AVE, WYNCOTE, PA 19095-2931
(215) 884-8815
(215) 884-5550
Mailing address
2827 W CHELTENHAM AVE, WYNCOTE, PA 19095-2931
(215) 884-8815
(215) 884-5550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD037419L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0615552
—
PA
01
—
093548
BLUE CROSS/BLUE SHIELD
PA
Enumeration date
04/11/2006
Last updated
02/18/2013
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