Provider Demographics
NPI:1073533972
Name:BELL, CLARICE MARIJETTA (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARICE
Middle Name:MARIJETTA
Last Name:BELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLARICE
Other - Middle Name:MARIJETTA
Other - Last Name:BELL-STRAYHORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4990 GUILFORD FOREST DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-9017
Mailing Address - Country:US
Mailing Address - Phone:404-457-9051
Mailing Address - Fax:404-343-1278
Practice Address - Street 1:5900 HILLANDALE DR
Practice Address - Street 2:SUITE 215
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3802
Practice Address - Country:US
Practice Address - Phone:770-322-9660
Practice Address - Fax:770-322-1981
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine