Individual
MR. CLIFFORD H MAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12 GRINDSTAFF COVE RD, SYLVA, NC 28779
(828) 586-0807
(828) 586-8490
Mailing address
PO BOX 1836, SYLVA, NC 28779
(828) 586-0807
(828) 586-8490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200300173
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138XC
BCBS
NC
05
—
5900095
—
NC
Enumeration date
02/16/2006
Last updated
12/19/2019
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