Individual
CLIFFORD WELDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15945 19 MILE RD STE 202, CLINTON TOWNSHIP, MI 48038-1147
(586) 285-9270
Mailing address
15945 19 MILE RD STE 202, CLINTON TOWNSHIP, MI 48038-1147
(313) 608-0254
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301054557
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166726
TOTAL HEALTHCARE
MI
01
—
0500966
BCBSM
MI
05
—
1528194545
—
MI
01
—
21606
OMNICARE
MI
01
—
7001298
CHAMPS
MI
01
—
CW054557
LICENSE
MI
01
—
M-006492
TRICARE
MI
01
—
P87524
BCN
—
01
—
QMXPR0020661
MOLINA
MI
Enumeration date
02/26/2007
Last updated
07/28/2021
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