Provider Demographics
NPI:1649202573
Name:CLAY, ANTHONY W (DO)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:W
Last Name:CLAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 CENTURIAN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2137
Mailing Address - Country:US
Mailing Address - Phone:302-366-8600
Mailing Address - Fax:302-366-5646
Practice Address - Street 1:1 CENTURIAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2137
Practice Address - Country:US
Practice Address - Phone:302-366-8600
Practice Address - Fax:302-366-5646
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC2-0006899207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE011445C71Medicare PIN
DEE60990Medicare UPIN