Provider Demographics
NPI:1093848418
Name:VOLNA CLERMONT, M.D., P.C.
Entity Type:Organization
Organization Name:VOLNA CLERMONT, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VOLNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERMONT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-341-7000
Mailing Address - Street 1:2434 PURITAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-1416
Mailing Address - Country:US
Mailing Address - Phone:313-341-7000
Mailing Address - Fax:
Practice Address - Street 1:2434 PURITAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-1416
Practice Address - Country:US
Practice Address - Phone:313-341-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301023027208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF42685OtherHEALTH PLAN OF MICHIGAN
MIF42685OtherTOTAL HEALTH CARE
MI004687OtherDMC CARE
MI3508216771OtherBLUE CARE NETWORK
MI3508216771OtherBLUE CROSS BLUE SHIELD
MI103167OtherGREAT LAKES HEALTH PLAN
MIF42685OtherPPOM
MI101004720Medicaid
MIF42685OtherHEALTH CHOICE
MIF42685OtherMCLAREN HEALTH PLAN
MIF42685OtherAUTOMATED BENEFITS SERVIC
MIF42685OtherAETNA
MIF42685OtherMIDWEST HEALTH PLAN
MIF42685OtherMCLAREN HEALTH PLAN