Provider Demographics
NPI:1477512085
Name:HSIAO, CLEMENT C (MD)
Entity Type:Individual
Prefix:DR
First Name:CLEMENT
Middle Name:C
Last Name:HSIAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3180 N POINT PKWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4248
Mailing Address - Country:US
Mailing Address - Phone:770-777-4933
Mailing Address - Fax:770-777-4934
Practice Address - Street 1:3180 N POINT PKWY
Practice Address - Street 2:SUITE 205
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4248
Practice Address - Country:US
Practice Address - Phone:770-777-4933
Practice Address - Fax:770-777-4934
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA53917207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA883049885AMedicaid
GA883049885AMedicaid
GA16BBCSQMedicare ID - Type Unspecified