Provider Demographics
NPI:1073688487
Name:POWELL, CLYDETTE LINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:CLYDETTE
Middle Name:LINDA
Last Name:POWELL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1050 N STUART ST
Mailing Address - Street 2:APT 902
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5710
Mailing Address - Country:US
Mailing Address - Phone:703-284-0439
Mailing Address - Fax:202-216-3702
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:CHILDREN'S NATIONAL MEDICAL CENTER, ID DIV-SIS CLINIC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2978
Practice Address - Country:US
Practice Address - Phone:202-712-0027
Practice Address - Fax:202-216-3702
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
DCMD339402084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology