Organization
MICHAEL W CLISHAM DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WILLIAM CLISHAM DPM (PODIATRIST)
(443) 460-0127
Entity
Organization
Contact information
Practice address
6304 KENWOOD AVE, 3, BALTIMORE, MD 21237
(443) 460-0127
(410) 866-6610
Mailing address
6304 KENWOOD AVE, 3, BALTIMORE, MD 21237
(443) 460-0127
(410) 866-6610
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00506
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
786108700
—
MD
Enumeration date
04/14/2008
Last updated
06/06/2008
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