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Individual

DR. RAYMOND JOSEPH CLYDESDALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
633 MEDICAL GROUP, 77 NEALY AVENUE, HAMPTON, VA 23665-2040
(757) 225-7630
Mailing address
633 MEDICAL GROUP, 77 NEALY AVENUE, LANGLEY AFB, VA 23665

Taxonomy

Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
OS12364
PA
2083X0100X
Occupational Medicine Physician
OS12364
PA
208D00000X
General Practice Physician
OS12364
PA

Other

Enumeration date
10/17/2005
Last updated
06/12/2024
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