Provider Demographics
NPI:1497129258
Name:MICHAEL E CLIFFORD M D PROF CORP
Entity Type:Organization
Organization Name:MICHAEL E CLIFFORD M D PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-944-5444
Mailing Address - Street 1:7151 CASCADE VALLEY CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0496
Mailing Address - Country:US
Mailing Address - Phone:702-944-5444
Mailing Address - Fax:702-944-4322
Practice Address - Street 1:7151 CASCADE VALLEY CT
Practice Address - Street 2:SUITE 103
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0496
Practice Address - Country:US
Practice Address - Phone:702-944-5444
Practice Address - Fax:702-944-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5960261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service