Individual
DR. MICHAEL R CLEMMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-1000
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6482
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0041415
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079171700
—
MD
01
—
2559709 2573474
AETNA HMO
MD
05
—
507000702
—
MD
01
—
52427806
CAREFIRST AAPG
MD
01
—
Y1220005
CAREFIRST AAPG
MD
Enumeration date
10/10/2005
Last updated
12/08/2013
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