Individual
MICHELLE DIZON CLEMENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
863 BUTTNER PL, SUITE 103, DOVER, DE 19904-2406
(302) 734-3331
(302) 734-9908
Mailing address
863 BUTTNER PL, SUITE 103, DOVER, DE 19904-2406
(302) 734-3331
(302) 734-9908
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C1-0007712
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232158285
BCBS PROVIDER ID NUMBER
DE
Enumeration date
11/08/2005
Last updated
05/22/2009
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