Individual
DR. MARY R CLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
2001 MEDICAL PKWY, ACUTE CARE PAVILION, ANNAPOLIS, MD 21401-3280
(443) 481-1000
(443) 481-6515
Mailing address
PO BOX 64916, BALTIMORE, MD 21264-4916
(443) 481-6469
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D38328
MD
207RI0200X
Infectious Disease Physician
D38328
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142441600
—
MD
01
—
53072411
BCBS MARYLAND
—
01
—
5926262
AETNA PPO
—
01
—
6263782
AETNA HMO
—
01
—
S3990059
BCBS DC
—
Enumeration date
01/03/2006
Last updated
10/05/2012
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