Provider Demographics
NPI:1003897729
Name:CLIFFEL, THOMAS P (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:CLIFFEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:14200 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4510
Mailing Address - Country:US
Mailing Address - Phone:216-521-5553
Mailing Address - Fax:216-521-1233
Practice Address - Street 1:14200 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4510
Practice Address - Country:US
Practice Address - Phone:216-521-5553
Practice Address - Fax:216-521-1233
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35030083207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0227730Medicaid
OH0380761Medicare PIN