Individual
CLIFFORD ALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
906 BUSINESS PARK DR, TRAVERSE CITY, MI 49686-8683
(800) 968-6866
Mailing address
PO BOX 3318, GRAND RAPIDS, MI 49501-3318
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101006940
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4602740
—
MI
01
—
CA006940
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/18/2005
Last updated
02/21/2008
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