Individual
DR. DAVID LEE CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 MEMORIAL DR, SUITE 624, SOUTH BEND, IN 46601-1063
(574) 282-2708
(574) 282-1044
Mailing address
621 MEMORIAL DR, SUITE 624, SOUTH BEND, IN 46601-1063
(574) 282-2708
(574) 282-1044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01024951
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084082
BCBS/ANTHEM
IN
Enumeration date
11/10/2005
Last updated
04/04/2011
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