Provider Demographics
NPI:1467729780
Name:SCHLEGEL, CLARENCE RICHARD (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:RICHARD
Last Name:SCHLEGEL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 RESERVOIR RD NW
Mailing Address - Street 2:RM W500
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2126
Mailing Address - Country:US
Mailing Address - Phone:202-687-1655
Mailing Address - Fax:
Practice Address - Street 1:3900 RESERVOIR RD NW
Practice Address - Street 2:RM W500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2126
Practice Address - Country:US
Practice Address - Phone:202-687-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20823207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology