Provider Demographics
NPI:1003065905
Name:CABANSAG, CLIFFORD QUINN (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:QUINN
Last Name:CABANSAG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CLIFF
Other - Middle Name:QUINN
Other - Last Name:CABANSAG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4302 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-6697
Mailing Address - Country:US
Mailing Address - Phone:513-433-1032
Mailing Address - Fax:513-433-1245
Practice Address - Street 1:4302 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6697
Practice Address - Country:US
Practice Address - Phone:513-433-1032
Practice Address - Fax:513-433-1245
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.099392207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine