Provider Demographics
NPI:1043971443
Name:CLIFFEL, ALBERT PAUL IV
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:PAUL
Last Name:CLIFFEL
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE # MS 1108
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2598
Mailing Address - Country:US
Mailing Address - Phone:419-383-3759
Mailing Address - Fax:419-383-2962
Practice Address - Street 1:3065 ARLINGTON AVE STE 2C
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2570
Practice Address - Country:US
Practice Address - Phone:419-383-3759
Practice Address - Fax:419-383-2962
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008113RX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical