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Individual

CLIFFORD GROVER WLODAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8121 NATIONAL AVE, STE 310, MIDWEST CITY, OK 73110-7530
(405) 737-3100
(405) 737-3109
Mailing address
8121 NATIONAL AVE, STE 310, MIDWEST CITY, OK 73110-7530
(405) 737-3100
(405) 737-3109

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
13905
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100006140C
OK
Enumeration date
04/13/2006
Last updated
06/24/2009
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