Provider Demographics
NPI:1033307111
Name:SOLARES, CLEMENTINO ARTURO (MD)
Entity Type:Individual
Prefix:DR
First Name:CLEMENTINO
Middle Name:ARTURO
Last Name:SOLARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE STE 1135
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2234
Mailing Address - Country:US
Mailing Address - Phone:404-778-3381
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE STE 1135
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2234
Practice Address - Country:US
Practice Address - Phone:404-778-3381
Practice Address - Fax:216-445-9409
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-14
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62082207YX0007X
OH57.005372207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology