Provider Demographics
NPI:1861835134
Name:CLARKE, CAMAEL (MPT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CAMAEL
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1319
Mailing Address - Country:US
Mailing Address - Phone:202-751-1882
Mailing Address - Fax:
Practice Address - Street 1:5323 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-1319
Practice Address - Country:US
Practice Address - Phone:202-751-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871945225100000X
MDPT22496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist