Provider Demographics
NPI:1134488380
Name:CHLON, CLARA FUENTES (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:FUENTES
Last Name:CHLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:NEONATOLOGY/PULMONARY ML 7009
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4830
Mailing Address - Fax:513-636-7868
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:NEONATOLOGY/PULMONARY ML 7009
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4830
Practice Address - Fax:513-636-7868
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.125128208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program