Provider Demographics
NPI:1942395629
Name:CLEMMER, RICHARD I JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:I
Last Name:CLEMMER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1401
Mailing Address - Country:US
Mailing Address - Phone:302-690-6404
Mailing Address - Fax:302-633-5591
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:302-633-5380
Practice Address - Fax:302-633-5591
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10002103207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery